Classification and treatment of open pneumothorax
Patients who have lung damage, can the diagnosis of open pneumothorax. Light surrounds the shell, which is called the pleura. This shell consists of two layers: the first layer of the lung, it directly surrounds the lung, the second layer of the wall, which is located after the first layer adjacent to the walls of the chest. The layers are connected by a fluid that is between them and created in the cavity of the negative pressure.
In case of possible injuries, trauma or lung after the disease into the pleural cavity can get air. If air gets inside, the pressure in the pleural cavity increases, the layers separated, the injured lung subsides and ceases to function properly. In medicine it is a pathological condition caused by the accumulation of air in the pleural cavity is called pneumothorax.
Classification of pneumothorax
You can select the following types of pneumothorax:
- one-sided, which is divided into right and left.
- By volume:
- Liaison with the environment:
- valvular pneumothorax or intense.
The traumatic form occurs due to penetrating trauma (e.g. gunshot wound) or closed (bruised lung). Spontaneous disease is characterized by the unexpected emergence of the violation of the integrity of the chest and lung tissue or in various diseases of the respiratory system and congenital anomalies. This kind of triggered a strong cough, laugh or exercise. Artificial pneumothorax is created intentionally for therapeutic interventions, eg, tuberculosis. This may be a biopsy that takes a small piece of lung for research or puncture in the pleural cavity is a hole for a fence of pathological content.
The most rare type of pneumothorax, the pathogenesis of which is unclear so far, it catamenial or menstrual type. Occurs in women of childbearing age, is characterized by recurring bouts of the disease. They coincide with the menstruation, but can also occur before or after it. Closed pneumothorax is the lightest form of the disease. Caused byclosed trauma, which does not violated the integrity of the thorax and the pleural cavity has no contact with the external environment. In this type of disease in the pleural cavity gets some air, it doesn't change when you breath, so often a closed form of the disease goes away.
Open pneumothorax occurs due to penetrating chest injuries, for example after a gunshot or knife wound. The pleural cavity is in contact with the external environment through a hole, which can be seen visually. When air enters the pleural cavity during breathing in and out when you exhale. The incoming air increases the pressure in the pleural cavity, so the lung with damaged side subsides and ceases to participate in the act of respiration. Outdoor double sided form of the disease is fatal.
Stressful kind of disease is the worst option. In this type the air passes into the pleural cavity during inspiration, but not released to the environment during expiration. Therefore, during the act of breathing in the pleural cavity is constantly increasing the volume of air. Easy with the damaged side is compressed and begins to put pressure on neighboring, healthy which leads to constriction of blood vessels and functional disruption of the lungs.
Total pneumothorax is characterized by complete compression of the lung. Two-way type is determined by the involvement in the pathological process of two lungs. In unilateral pneumothorax in the process involves only one lung. This species is divided into right, which affects the right lung and the left. A limited pneumothorax is accompanied by compression of light not full.
Symptoms and diagnosis
Symptoms of the disease depends on its type. It can occur in a variety of injuries and traumas, traumatic pneumothorax during spontaneous or sudden. Man complains of sharp chest pain that intensifies when breathing in. The heartbeat quickens, there is a feeling of fear due to the lack of air, so the person tries to breathe more often and deeper. The larger the pneumothorax, the more affected the respiratory apparatus. There is a significant shortness of breath, is the compression of blood vessels, oxygen stops to flow into the blood, the skin becomes pale or bluish tint. To facilitate patient takes a forced position. In unilateral pneumothorax visually you can see enlarging the damaged half, lagging it in the act of respiration. With an open pneumothorax there is a wound through which during exhalation, blood is allocated.
The diagnosis is made on the basis of commoninspection that consists of a visual examination of the chest and auscultation with a stethoscope. Also conducted x-rays, it is possible to see sections of the enlightenment and the displacement of the organs. When carrying out the puncture revealed the air. Among the laboratory indicators used by the study of gas composition of arterial blood. The study observed hypoxemia, i.e. reduction of oxygen in the blood.
Treatment of pneumothorax
All patients with the disease are hospitalized, carried out adequate treatment and eliminate the causes of disease.
The doctor should carry out the removal of air and restore negative pressure in the pleural cavity. When a closed form possible self-absorption of air in the pleural cavity. If the air is not out, so you need to hold an emergency puncture. The cause for undergoing surgery.
When the valve type you need to reduce intrapleural pressure by puncture and drain using a special tube through which the air will escape from the pleural cavity. With an open pneumothorax the patient is provided the rest. Apply a bandage on the wound, which isolates the pleural cavity, and with the help of puncture produces a negative pressure. The bandage should be tight and not leak air. In the case of first aid it can be a regular plastic bag. To reduce pain prescribe painkillers, analgesics. In the surgical hospital sutured the wound to the air is not admitted to the pleural cavity. Catamenial pneumothorax treated with hormones.
A patient who has a suspicion for pneumothorax requires emergency hospitalization, providing medical assistance and adequate treatment the prognosis is favorable. A tension pneumothorax is considered to be very dangerous for life and could face a fatal outcome in the absence of timely medical care.