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Tension pneumothorax

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Pneumothorax - tension

Treatment:

If you have symptoms of tension pneumothorax, seek immediate medical treatment.

The objective of treatment is to remove the air from the pleural space, allowing the lung to re-expand. In an emergency, a small needle (such as a standard intravenous needle) may be placed into the chest cavity through the ribs to relieve the excessive pressure.

The definitive treatment is a chest tube, a large plastic tube that is inserted through the chest wall between the ribs to remove the air completely. The chest tube is attached to a vacuum bottle that slowly and continuously removes air from the chest cavity. This allows the lung to re-expand. As the lung heals and stops leaking air, the vacuum is turned down and then the chest tube is removed. Hospitalization is required for proper care of the chest tube and because several days may be required before the affected lung re-expands.

Surgery may be indicated for recurrent episodes or if the lung does not re-expand after 5 days with a chest tube in place.

Expectations (prognosis):

Up to 50% of patients who have a pneumothorax will have another. There are no long-term complications following successful therapy.

Complications:

• Acute respiratory failure
• Pneumomediastinum (air in the mediastinal space, which can interfere with heart and lung functioning)
• Shock (extremely low blood pressure)
• Death

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms of this disorder are present.

References:

Murray J, Nadel J. Textbook of Respiratory Medicine . 3rd ed. Philadelphia, Pa: WB Saunders; 2000. 

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 5th ed. St. Louis, Mo: Mosby; 2002.

• Review Date: 8/10/2005
• Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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