Spontaneous Pneumothorax

WHAT YOU SHOULD KNOW:

• A spontaneous pneumothorax is a condition in which air collects in the pleural space (the space between your lung and chest wall). When a pneumothorax occurs, the lung can collapse, making it hard for you to breathe. This happens because the air between the lung and the chest wall prevents the lung from filling with air. A spontaneous pneumothorax can happen in one or both of your lungs. A primary spontaneous pneumothorax occurs in a person with no known lung disease. A secondary spontaneous pneumothorax is when a person has a known lung disease or medical condition. While a pneumothorax is often caused by trauma, a spontaneous pneumothorax happens without a clear cause. A spontaneous pneumothorax may occur when an air pocket or bleb (fluid-filled sac) in the lung breaks open. This allows air to leak out and become trapped in the pleural cavity. Air may also enter the pleural space if your lung tissue is damaged and becomes porous (has small tissue openings).
  
  
• A spontaneous pneumothorax may cause you to have shortness of breath, chest pain, and a fast heartbeat. A tension pneumothorax may occur making it hard for your lungs and heart to work properly. A tension pneumothorax may become life-threatening. The risk for a spontaneous pneumothorax is higher in tall, thin males, smokers, and in people with lung disease. Imaging tests, such as a chest x-ray or computed tomography (CT) scan may be done to diagnose your pneumothorax. A small spontaneous pneumothorax may heal on its own without treatment. Treatment includes needle aspiration, chest tubes, or surgery to repair your lung. Treatment may allow your lung to fill with air, making it easier for you to breathe. Your other symptoms, such as chest pain, may resolve and your heart and lungs will function better.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Some treatments may cause breathing problems or problems in your heart or blood vessels. Treatments needing cuts in your skin to get to your lung area may lead to empyema. Empyema is an infection in the lung area. Air may become trapped under your skin causing your skin to bulge out or feel crackly. The needle used during needle aspiration may injure your lung or cut a blood vessel. This can cause bleeding around your lung. Chest tubes may cause pain and may become kinked or clogged, or could leak or fall out. Chest tubes could also cause a lung infection, or fluid could fill your lung instead of air. Chest tubes may also damage blood vessels or other organs and cause bleeding, injury, and even death. Even with treatment, you may continue to have an air leak or you may have another spontaneous pneumothorax.
  
  
• Air may continue to enter the pleural space and you may get a tension pneumothorax. With a tension pneumothorax, the injured lung and trapped air push against your uninjured lung. A tension pneumothorax can lead to low blood pressure, decreased oxygen in your blood, and heart problems. Without treatment of your spontaneous pneumothorax, your lung or lungs may completely collapse. Your heart could stop working, and you could die. Talk with your caregiver if you have any questions or concerns about your treatment, condition, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Oxygen:

You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

• Medicines:
  
  
  • Pain Medicine: Caregivers may give you medicine to take away or lessen your pain. Tell caregivers if the pain does not go away or comes back.
    
    
  • Antibiotic medicine: You may be given antibiotic (germ-killing) medicine if a lung infection caused your spontaneous pneumothorax.
  
  
• Monitoring:
  
  
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
    
    
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Tests: You may need any of the following tests to help caregivers plan your treatment.
  
  
  • Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
    
    
  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
    
    
  • Chest X-ray: This is a picture of your lungs and heart. Caregivers may use the x-ray to check the size of your pneumothorax. The x-ray can show if you have fluid around your heart and lungs. You may also have a chest x-ray after treatment for your pneumothorax. This is done to check if your lung is filling with air properly.
    
    
  • Computerized tomography scan: A CT scan uses a special x-ray machine to take pictures of your chest and lungs. A CT scan may help caregivers plan your treatment. You may be given dye through an IV before the pictures are taken. The dye will help the pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies.
  
  
• Treatment options: You may need one or more of the following:
  
  
  • Chest tube: A chest tube may be placed to remove air, blood, or fluid from around your collapsed lung. This allows your lung to fill up with air when you breathe, and helps your heart beat normally. The chest tube is attached to a container to remove air and collect any blood or fluid. You may need a chest tube to treat your spontaneous pneumothorax or after having surgery to treat your pneumothorax.
    
    
  • Needle aspiration: During needle aspiration, a needle, with a tube over it, is put through your skin and into your pleural cavity. Using a syringe, your caregiver pulls the air out of your pleural space.
    
    
  • Pleurodesis: For pleurodesis, your caregiver will use chemicals, powder, or pieces of cloth to irritate the walls of your pleural space. Before the procedure, fluid and air may be drained from the pleural space. Pleurodesis causes the walls of your pleural space to become attached to each other. This may help prevent air or fluid from collecting in your pleural space. Pleurodesis may be done alone or after surgery to treat your spontaneous pneumothorax.
    
    
  • Surgery:
    
    
    • Thoracotomy: During a thoracotomy, an incision (cut) is made in your chest to repair your lung.
      
      
    • Video-assisted thoracoscopic surgery: Video-assisted thoracoscopic surgery (VATS) is surgery done to look inside your chest with a video scope. During surgery, 2 to 3 small cuts are made between your ribs. The video scope and other special instruments are inserted into these incisions to repair your lung.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Spontaneous Pneumothorax (Inpatient Care)