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    Types of Pneumothorax

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    There are two main types of pneumothorax: spontaneous and traumatic. Spontaneous pneumothorax can be primary or secondary based on underlying lung disease. Traumatic pneumothorax results from chest trauma or medical procedures. Tension pneumothorax is a medical emergency that occurs when air enters the pleural space but cannot exit, causing compressed lungs and reduced blood return. Clinical features range from minimal to severe respiratory distress depending on severity.

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    Types of Pneumothorax

    Uploaded by

    umar
    129 views13 pages
    There are two main types of pneumothorax: spontaneous and traumatic. Spontaneous pneumothorax can be primary or secondary based on underlying lung disease. Traumatic pneumothorax results from chest trauma or medical procedures. Tension pneumothorax is a medical emergency that occurs when air enters the pleural space but cannot exit, causing compressed lungs and reduced blood return. Clinical features range from minimal to severe respiratory distress depending on severity.

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    Pneumothorax

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    types of Pneumothorax

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    There are two main types of pneumothorax: spontaneous and traumatic. Spontaneous pneumothorax can be primary or secondary based on underlying lung disease. Traumatic pneumothorax results from chest trauma or medical procedures. Tension pneumothorax is a medical emergency that occurs when air enters the pleural space but cannot exit, causing compressed lungs and reduced blood return. Clinical features range from minimal to severe respiratory distress depending on severity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    129 views13 pages

    Types of Pneumothorax

    Uploaded by

    umar
    There are two main types of pneumothorax: spontaneous and traumatic. Spontaneous pneumothorax can be primary or secondary based on underlying lung disease. Traumatic pneumothorax results from chest trauma or medical procedures. Tension pneumothorax is a medical emergency that occurs when air enters the pleural space but cannot exit, causing compressed lungs and reduced blood return. Clinical features range from minimal to severe respiratory distress depending on severity.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 13

    Types of

    Pneumothorax
    Types of Pneumothorax
    • 2 main types based on cause: spontaneous and
    traumatic
    • Can also be classified according to communication
    between pleural space and airway
    1. Spontaneous Pneumothorax

    • Can be divided into primary and secondary


    • Primary = no underlying pulmonary disease
    • Secondary = with underlying pulmonary disease
    • Primary Spontaneous Pneumothorax (PSP)
    • Occurs as a result of spontaneous rupture of blebs or
    bullae
    • Presence of asymptomatic blebs and bullae (usually
    apical)
    1. Spontaneous
    Pneumothorax
    • Risk factors:

    • Smoking • 80-90% PSP in smokers


    • Familial association • >10% PSP have familial
    association (some due to
    connective tissue disorders e.g
    Marfan syndrome)
    • Tall, thin stature
    • Increased
    intrathoracic pressure
    • Changes in
    atmospheric pressure
    • Secondary Spontaneous Pneumothorax (SSP)
    • Occurs in the presence of known lung disease
    • Associated with increased symptoms, morbidity and
    higher rates of developing tension pneumothorax
    • Causes:
    Obstructive airway disease • COPD
    • asthma
    Suppurative lung disease • Bronchiectasis
    • Cystic fibrosis
    Malignant disease • Lung carcinoma
    • Secondary metastasis
    Interstitial lung disease • sarcoidosis
    • Wegener’s granulomatosis
    • Idiopathic interstitial fibrosis
    • lymphangioleiomyomatosis

    Infections • Pneumocystis jirovecii pneumonia


    (in patients with AIDS )
    • tuberculosis
    2. Traumatic & Iatrogenic
    • Traumatic pneumothorax causes include:
    • Trauma - Penetrating and nonpenetrating injury
    • Rib fracture
    • High-risk occupation (eg, diving, flying)
    • Traumatic pneumothorax can often lead to
    formation of one-way valve causing tension
    pneumothorax
    2. Traumatic & Iatrogenic
    • Iatrogenic pneumothorax occurs as a complication
    of medical or surgical procedures.
    • Iatrogenic pneumothorax causes include:
    • Central vein cannulation
    • Pleural tap or biopsy
    • Transthoracic needle aspiration biopsy
    • Transbronchial biopsy
    • Fine needle aspiration
    • Positive pressure ventilation - High peak airway
    pressures results in pulmonary barotrauma
    Tension Pneumothorax
    • Is a medical emergency
    • Occurs when the communication between the
    airway and pleural space acts as a one-way valve.
    • Air enters pleural space during inspiration but is not
    expelled during expiration
    • High intrapleural pressure causes mediastinal shift
    to opposite side, compression of contralateral lung
    and reduced venous return, causing cardiovascular
    compromise.
    Tension Pneumothorax
    • Usually traumatic or iatrogenic causes
    • Includes:
    • Blunt or penetrating trauma - often associated with rib
    fractures
    • Barotrauma secondary to positive-pressure ventilation
    (PPV), especially when high amounts of positive end-
    expiratory pressure (PEEP) are used
    • Percutaneous tracheostomy
    • Conversion of spontaneous pneumothorax to tension
    pneumothorax
    Clinical Features
    • Symptoms
    • Sudden onset of unilateral pleuritic chest pain and/or
    breathlessness
    • Depending on severity of pneumothorax, symptoms can
    be well-tolerated
    • Usually more severe in SSPs due to existing lung disease
    • Other symptoms include: anxiety, cough, generalised
    malaise and fatigue
    • History of previous similar episodes: high rates of
    recurrence especially with SSPs
    • History of other pulmonary disease and thoracic
    procedures may indicate cause of pneumothorax
    Clinical Features
    • Signs
    • Depending on severity, presentation may range from
    minimal findings to severe respiratory distress
    Respiratory • Respiratory distress
    • Tachypnoea (bradypnea in later stages)
    • Tracheal deviation to opposite side* – late sign
    • Ipsilateral reduced chest movements
    • Reduced tactile fremitus
    • Hyperresonance on percussion
    • Reduced or absent breath sounds unilaterally
    • Adventitious lung sounds (features of
    underlying disease)

    Cardiovascular • Tachycardia - most common finding


    • Pulsus paradoxus*
    • Hypotension*
    • Jugular venous distention*
    • Cardiac apical displacement* – rarely seen
    *more commonly seen and marked in tension pneumothorax
    Clinical Features
    • In tension pneumothorax,
    • Symptoms and signs are usually more severe
    • There is rapidly progressive breathlessness and chest
    pain in addition to air hunger and increased anxiety
    • In patients on PPV, ventilation becomes progressively
    more difficult
    • Cyanosis may be present
    • Cardiac signs such as tachycardia and hypotension are
    more marked
    • Advanced (pre-terminal) stage is characterised by
    reduced breathing rate, reduced consciousness and
    hypotension

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