Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PNEUMOTHORAX”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Pleural abrasion in the treatment of recurrent or persistent spontaneous pneumothorax. Results of 94 consecutive cases.

In the ten-year period 1982 to 1991, 94 patients underwent pleural abrasion as definite treatment for spontaneous pneumothorax. Surgical indications included: 1) third recurrence of homolateral pneumothorax, 2) second recurrence of homolateral pneumothorax in the presence of alternating pneumothorax, and 3) persistent air leak with incomplete lung re-expansion in the presence of spontaneous pneumothorax treated with pleural drainage for more than 10 days. No deaths were observed in the present series. Post-operative complications were minimal and all reversible, including two cases of pleural effusion, one case of hemothorax, and one case of Horner's syndrome. Eighty cases were followed up from 7 to 91 months. No recurrences occurred during the follow-up period. Clinical, radiological and functional results appear satisfactory. Pleural abrasion seems to represent a valid surgical option in the treatment of recurrent or persistent spontaneous pneumothorax.

Adolescent↗
PubMed2006

[Thoracoscopic surgery for pneumothorax].

It is difficult to tell clearly what a therapy for pneumothorax is because it is not enough just to cut away the bullae. The patients should be treated mentally, physically and less invasively. The 4 anxieties should be solved for pneumothorax patients. Four anxieties for symptom, the normal side of lung, the effect after therapy and surgery. In thoracoscopic surgery on pneumothorax, to cut away just the bullous change does not mean to prevent the postoperative recurrence. Added treatments need beside resection of bullae because bullae often tend to regenerate near the suture line soon after thoracoscopic surgery. The covering method is the most effective in some added treatments. It is a method of covering regenerative oxidized cellulose mesh and fibrin glue on the suture line. Classification of air leakage level that was designed in Pneumothorax Research Center is clinically useful. This classification forms from level 1 to 4 according to air leakage volume and pressure level. It is important to resolve the mechanism on postoperative regeneration of bullae at this point in order to ask for better surgery. Female pneumothorax and less than 15-year-old pneumothorax should be researched because they cause frequently postoperative recurrence.

Adolescent↗
PubMed1991

[Three cases of catamenial pneumothorax].

Three cases of catamenial pneumothorax were presented. A 42-year-old woman with intrapelvic endometriosis had recurrent right-sided pneumothorax with menstruation more than six times. At the operation only a bleb was noted at the apex of the right lung. In a 16-year-old woman who already had been operated on for recurrent right-sided pneumothorax one year ago, left-sided pneumothorax occurred on the day of the beginning of each menstruation four times. A small bleb was noted at the apex. A 29-year-old woman with cesarean section at the age of 25 had recurrent right-sided pneumothorax occurring on the day before the beginning of menstruation three times. Though the operation was performed during her menstrual period, neither air leakage nor any lesions were found. In all cases each lesion was resected and did not prove endometriosis, and partial parietal pleurectomy was performed for pleurodesis. No pneumothorax has recurred.

Adolescent↗
PubMed1990

Surgical management of spontaneous pneumothorax.

From 1982 to 1989, 293 patients with spontaneous pneumothorax were treated at VGHTC. There were 251 males and 42 females, aged 1-85 years, mean 49.3 years. The location of pneumothorax included right side 148 cases, left side 129 cases and bilateral 16 cases. The treatment included tube thoracostomy in 282 cases, thoracotomy abrasive pleurodesis in 39 cases, median sternotomy bilateral abrasive pleurodesis in 31 cases and chemical pleurodesis in 18 cases. Indications for pleurodesis included (1) recurrent pneumothorax (2) bilateral pneumothorax (3) persistent air leakage more than 7 days (4) massive air leakage (5) complications of pneumothorax. From our study, we concluded that: (1) The simplest management for spontaneous pneumothorax is tube thoracostomy. (2) In young adults or suspicious bilateral lesions, median sternotomy with bilateral abrasive pleurodesis is first choice of management for some special indications. (3) In aged patients or patients needing concomitant procedure for other pulmonary disease, thoracotomy abrasive pleurodesis is better choice. (4) When poor lung function and contraindicated to have an operation, chemical pleurodesis can also get some advantages.

Adult↗
PubMed1990

[Echography of pneumothorax].

Ultrasound of 28 radiologically confirmed cases of pneumothorax were compared to 100 controls. Specific ultrasonographic signs were shown in all cases and could be categorised into four groups: isolated pneumothorax (n = 16), hydro-pneumothorax (n = 9), subcutaneous emphysema (n = 1) and post aspiration pneumothorax (n = 2). The isolated pneumothorax was characterised by the disappearance of the lung deflection signal. The effusion of the hydropneumothorax allows in addition a curtain sign which depicts the movement of the air/fluid level, the detachment of the lung being calculated across the liquid window whose echo-structure is analysed. Pneumothoraces appearing during an echo guided thoracic puncture are confirmed by the disappearance of the pathological image. Thus echography appears to be a new method in the diagnosis of pneumothoraces and is complimentary to standard radiology. It should be confirmed as particularly useful during the process of thoracic puncture or juxta-diaphragmatic puncture when following the process of a pneumothorax, for emergency situations and/or those in which no radiological equipment is available.

Aged↗
PubMedDate not supplied

Cardiovascular and respiratory consequences of tension pneumothorax.

The physiologic responses to acute pneumothorax were investigated in awake, standing sheep. Pleural pressure (Ppl) was raised in graded increments by injecting air from a 500 ml syringe into the pleural cavity of eight sheep to produce pneumothorax volumes of 0, 17, 35 and 45 ml.kg-1. At the maximum value of 45 ml.kg-1 (approximately equal to 1,400 ml), Ppl at end-expiration was raised to 10 +/- 2 mmHg (mean +/- SD) whereas end-inspiratory Ppl remained negative in half the sheep as the result of increased thoracic pressure swings. The most striking haemodynamic impairment was a 22% fall in stroke volume. Cardiac output, however, remained fixed at baseline values as a result of a 28% rise in heart rate. Although hypotension has been commonly held as a consequence of severe pneumothorax, mean systemic arterial pressure increased, rising by 19% in the entire group at the maximal pneumothorax tolerated. Pulmonary gas exchange was significantly disrupted by pneumothorax, as indicated by both a 40% fall in Pao2 and a 19% reduction in arterial oxygen content. Despite a reduction in tidal volume, the sheep initially remained eucapnic by generating an increased respiratory rate and slightly increasing minute-ventilation. However, at pneumothorax volumes of 45 ml X kg-1, the sheep were no longer able to sustain minute-ventilation and a small rise in PaCO2 followed. The reduced arterial oxygen content and the fixed cardiac output led to a progressive reduction in systemic oxygen transport.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

Pneumothorax during positive-pressure mechanical ventilation.

The hemodynamic and respiratory effects of unilateral pneumothorax were studied during positive-pressure mechanical ventilation in five sheep. The sheep were anesthetized, intubated, and placed on mechanical ventilation with positive end-expiratory pressure (5 cm H2O). After baseline studies, including chest roentgenograms, were taken, increments of air were injected into the right pleural cavity. Measurements were repeated at pneumothoraces of 500, 1,000, and 1,500 ml. There was a steady fall in cardiac output (p less than 0.02) at pneumothoraces of 1,000 and 1,500 ml. The decrease in cardiac stroke volume paralleled that of cardiac output. Heart rate rose (p less than 0.05) at a pneumothorax of 1,500 ml. There appeared to be a linear relationship between the percent increase in pneumothorax as estimated by roentgenogram and the percent fall in cardiac output (r = 0.991). There was a steady rise in mean pulmonary arterial, pulmonary arterial capillary wedge, superior vena caval, and inferior vena caval pressures, although the changes in inferior vena caval pressure were not statistically different from baseline. Peak airway pressure increased from baseline at pneumothoraces of 1,000 and 1,500 ml. Both right and left end-expiratory intrapleural pressures increased and were statistically different (p less than 0.01) from baseline. However, there was a substantially greater rise in right intrapleural pressure than left. Arterial oxygen tension remained physiological throughout the study. This study indicates that cardiac output decreases as the amount of pneumothorax increases in sheep during mechanical ventilation. This study also demonstrates that, during positive-pressure mechanical ventilation, a relatively benign-appearing pneumothorax by chest roentgenogram may be associated with a significantly depressed cardiac output. In addition, arterial oxygen tension may not be useful in predicting the onset of pneumothorax during mechanical ventilation.

Animals↗
PubMed1984

[Pneumothorax as a cause of acute and recurrent neonatal hypoxia].

In 191 children suffering from RDS treated by mechanical ventilation or CPAP + PEEP according to the same protocol the incidence of pneumothorax was determined with 23% (44 infants). Mean birthweight and mean gestational age were lower in infants who developed pneumothorax. Pneumothorax occurred more frequently in children with bad pre- and perinatal history. Children who developed pneumothorax had received a lower fluid intake than those without. Incidence varied with severity of RDS and intensity of respiratory assistance. We tried to asses the duration and severity of hypoxia by means of transcutaneous pO2 measure and arterial blood gas analyses. As fast diagnosis and therapy helps to shorten the duration of hypoxia, we listened up the most frequent alternations of vital signs associated with pneumothorax. We found cyanosis, changes in heart rate and respiratory rate, arterial blood pressure and decrease of paO2. Hints to avoid a pneumothorax are given.

Humans↗
PubMed1995

[Residual postoperative pneumothorax: harmless radiological finding or complication-prone diagnosis?].

470 patients underwent either lobectomy, bilobectomy or decortication at our institution between 1980 and 1991. A residual postoperative pneumothorax was observed in 20.7% of the patients at discharge after removal of the chest tubes. There was no significant correlation between the development of a residual postoperative pneumothorax and the patient's age and gender, the type of operation (lobectomy vs bilobectomy vs decortication) and the date of operation (as related to the introduction of stapling devices). This residual postoperative pneumothorax at discharge resolved without any further treatment in 95% of the patients during follow-up. Complete regression was observed in 91% of the patients within one year after the operation and the duration of regression did not correlate with the size of the pneumothorax at discharge. No empyema was observed in any patient with residual pneumothorax during follow-up, which also holds true for patients who underwent resection or decortication for inflammatory disease. We conclude that there is no need for treatment of residual postoperative pneumothorax, either with space-filling maneuvers at the initial operation or repeat chest tube insertions during follow-up, provided there is no evidence of lung collapse.

Female↗
PubMed1993

Delayed pneumothorax after central venous access: a potential hazard.

Percutaneous central venous catheter access is common-place in surgical patients. Though several major complications of this procedure have been described, pneumothorax is the most common. Pneumothorax is routinely assessed by a chest X-ray within 2 hours after catheter placement. During a recent 6-month interval, the authors identified five patients with delayed onset and diagnosis of pneumothorax following percutaneous central venous access. All immediate post-insertion chest X-rays were normal; however, subsequent chest X-ray showed evidence of pneumothoraxes. The pneumothorax contributed to the death of one patient on positive pressure ventilation. A review of the literature revealed a total of 18 patients in the English literature with this complication. Although the incidence of delayed pneumothorax is low, it is, in some instances, life threatening, particularly in patients on positive pressure ventilation. A high index of suspicion is required to diagnosis and treat this reversible condition.

Adult↗
PubMed1995

[Primary lung cancer presenting as spontaneous pneumothorax].

Pneumothorax is a rare manifestation of lung cancer. The mechanism by which pneumothorax occurs in lung cancer is not clear, and differing views have been expressed. Among 180 adults who presented with spontaneous pneumothorax from 1980 to 1992, eight had lung cancer: seven had squamous cell carcinoma and one had adenocarcinoma. All were men between 50 and 81 years old (average age, 66 years). In all patients, the pneumothorax occurred on the same side as the carcinoma. Thoracotomy was done in four patients. The results obtained by surgery indicated that pneumothorax may be caused by: 1) direct invasion of tumor into the pleura (patient 1); 2) rupture into the pleural space of dilated alveoli that are distal to the site of stenotic bronchial cancer (patient 7); 3) rupture into the pleural space of alveoli that had become distended to compensate for atelectasis due to obstructive bronchial cancer (patient 6); and 4) unknown (patient 2). These results suggest that lung cancer should always be considered as a possible cause of spontaneous pneumothorax in older patients.

Adenocarcinoma↗
PubMedDate not supplied

[Spontaneous pneumothorax and breast cancer].

BACKGROUND: Spontaneous pneumothorax with concomitant neoplastic diseases is unusual. Lung cancer and osteogenic sarcoma with pulmonary metastasis are the neoplasms that most frequently accompany the spontaneous pneumothorax. This article's purposes are to relate the occurrence of spontaneous pneumothorax associated with breast neoplasms and to discuss the main etiopathogenic factors involved in the process. MATERIAL AND METHODS: The authors report a case of a 43-year-old black woman carrier of a left breast ductal carcinoma with bilateral pulmonary metastasis. Spontaneous pneumothorax appeared during multidrug chemotherapy, so it cannot be related to other causes. CONCLUSIONS: Even though breast neoplasms cause lung metastases in about 60% of the cases, the coexistence of spontaneous pneumothorax and breast carcinoma is very rare. There was no report of this topic in the medical literature review during the last five years. The authors believe and discuss the multiple pneumothorax etiopathogenic factors related to this case.

Adult↗
PubMed1996

[Menstruation-associated (catamenial) pneumothorax and catamenial hemoptysis].

We report on 2 patients with catamenial pneumothorax and one patient with catamenial hemoptysis. The pathogenesis of these diseases is not clear, and intrathoracic endometriosis is often assumed. Catamenial pneumothorax is rare and differs from primary spontaneous pneumothorax in its prevalence in the fourth decade and in mainly multiparous women, its recurrent and almost exclusively right-sided occurrence within 72 hours of the beginning of menstruation, and the generally small size of the pneumothorax. About 5% of women under 50 presenting with primary pneumothorax have catamenial pneumothorax. Prevention of recurrence is difficult, as the recurrence rate is high, treatment duration is potentially long, and residual thoracic pain during menstruation is sometimes seen. The combination of medication (Gn-RH analogues, danazol, possibly hormonal contraceptive drugs or progestagens) with efficient pleurodesis (e.g. thoracoscopic talc application preferentially performed during menstruation) seems so far to be the most efficient, although no controlled studies have yet been performed. Catamenial hemoptysis is very rare and hormonal treatment alone is frequently successful in the long term. In the event of relapse, resection of the implicated endometriotic or angiomatous lesion localized by computed tomography can be performed.

Adult↗
PubMedDate not supplied

[Difficulties in differential x-ray diagnosis of restrictive pneumothorax in young children].

To define X-ray signs of restrictive pneumothorax, the authors analyzed X-ray films of 225 newborns and babies of the first 3 months of life who were examined for respiratory disorders and acute respiratory diseases. Restrictive pneumothorax was detected in 19 (8.44%) infants. In 14 patients, gas was present in limited areas of various portions of the pleural cavity, without causing collabation of the lung and displacing the mediastinum, which makes diagnosis difficult. Moreover, the thoracic superimposition of the border of the scapula, soft tissue of the shoulder, hypoventilation of the lower lobe simulated restrictive pneumothorax in 38 children. Examinations in the lateral position on the healthy side, X-ray made in milder modes than as accepted, dynamic studies were helpful in diagnosing restrictive pneumothorax. However, additional X-ray study increased radiation loads. The concordance of X-ray images of the available X-ray films on a UAP-2 device in 47 children enabled the presence of pneumothorax to be specified by the segregated outlines of the partially collabated lung and by the absence of a lung pattern outside. In hypoventilation of the lower lobe, a lung pattern was identified both in the hypoventilated and in the normal midlobe. The processing of X-ray films on the UAP-2 device enhanced the accuracy of restrictive pneumothorax diagnosis in infants and made it possible to do away an additional X-ray study, which reduced radiation loads.

Age Factors↗
PubMed1998

Spontaneous pneumothorax: determinants of surgical intervention.

OBJECTIVE: To assess the long term efficacy of intercostal tube drainage for spontaneous pneumothorax and determine the clinical parameters associated with surgery. EXPERIMENTAL DESIGN: Retrospective analysis with a mean follow-up of 62.3+/-19.3 months (range 23 to 94 months). SETTING: Riyadh Medical Complex, Riyadh (Saudi Arabia), the biggest referral centres for Ministry of Health providing specialized hospital care. PATIENTS: Over a period of six year, 123 patients had 182 episodes of spontaneous pneumothorax. Male to female ratio was 29.75:1 (p=0.00001). Average age was 26.35+/-8.33 years for men and 37.25+/-14.6 years for women (p=0.01). Seventy eight per cent of patients were aged 11 to 30 years (p=0.00001). Majority were nonsmokers (100/123, p=0.00001). It was first episode of spontaneous pneumothorax for 86 patients. Other 37 patients had 57 episodes previously (mean 1.54+/-0.73; range 1 to 4). INTERVENTIONS: Intercostal tube drainage for all patient with spontaneous pneumothorax. Limited axillary thoracotomy with bullectomy and pleuroabrasion for 32 patients not responding to intercostal tube drainage. RESULTS: Intercostal tube drainage alone had success rate of 90.7% in first, 52.4% in second, 15.4% in third and 0% for more than 3 episodes of spontaneous pneumothorax. Among the 32 patients who underwent surgery, only one had early recurrence that did not require drainage. We found that patients with history of recurrence, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung were more liable to undergo surgical intervention (p=0.00001 for all variables). CONCLUSIONS: We recommend early surgery to hasten recovery and shorten the hospital stay in patients with history of recurrent spontaneous pneumothorax, respiratory distress and those requiring tube thoracostomy for more than 4 days and negative suction to expand the lung.

Adult↗
PubMed2001

Ultrasound evaluation of the magnitude of pneumothorax: a new concept.

Pneumothorax is commonly seen in trauma patients; the diagnosis is confirmed by radiography. The use of ultrasound where radiographic capabilities are absent, is being investigated by the National Aeronautics and Space Administration. We investigated the ability of ultrasound to assess the magnitude of pneumothorax in a porcine model. Sonography was performed on anesthetized pigs in both ground-based laboratory (n = 5) and microgravity conditions (0 x g) aboard the KC-135 aircraft during parabolic flight (n = 4). Aliquots of air (50-100 cm3) were introduced into the chest to simulate pneumothorax. Results were videorecorded and digitized for later interpretation. Several distinct sonographic patterns of partial lung sliding were noted including the combination of a sliding zone with a still zone and a "segmented" sliding zone. These "partial lung sliding" patterns exclude massive pneumothorax manifested by a complete separation of the lung from the parietal pleura. In 0 x g, the sonographic picture is more diverse; one x g differences between posterior and anterior aspects are diminished. Modest pneumothorax can be inferred by the ultrasound sign of "partial lung sliding." This finding, which increases the negative predictive value of thoracic ultrasound, may be attributed to intermittent pleural contact, small air spaces, or alterations in pleural lubricant. Further studies of these phenomena are warranted.

Animals↗
PubMed1989

Catheter aspiration for simple pneumothorax. Experience with 114 patients.

Between 1983 and 1987, 114 adult patients with 131 pneumothoraces were treated utilizing catheter aspiration for simple pneumothorax as an alternative to tube thoracostomy. The causes of simple pneumothorax were as follows: 79 needle-induced, 36 spontaneous, and 16 traumatic. Thirty-eight of the pneumothoraces were small (less than 20% of volume), 55 were moderate (20% to 40% of volume), 36 were large (greater than 40% of volume), and 2 were of unknown size. Overall, catheter aspiration for simple pneumothorax was successful in 90 patients (69%). The success rate was 75% with needle-induced, 53% with spontaneous, and 75% with traumatic pneumothoraces. Small pneumothoraces were successfully managed with catheter aspiration for simple pneumothorax in 87% of patients, moderate-sized in 60%, and large in 61%. There were three complications (2.3%), including one hemothorax and two retained sheared catheter tips. The average cost per patient was +868 for catheter aspiration, and $6402 for a tube thoracostomy. These data support catheter aspiration as a safe, cost-effective, and successful technique for managing simple pneumothorax.

Adolescent↗
PubMed1982

The risk of spontaneous pneumothorax in patients with osteogenic sarcoma and testicular cancer.

Seven cases of unilateral, spontaneous pneumothorax were found in a retrospective study of 63 patients with osteogenic sarcoma who were admitted to The Norwegian Radium Hospital (NRH) in the period 1970--1977. The relative risk of pneumothorax developing doubled, from 7--14%, after the introduction of chemotherapy for this disease at NRH. This difference was not statistically significant. Pneumothorax developed in two of 18 patients (11%) with lung metastases who never received chemotherapy. Pneumothorax occurred in four of 19 patients (21%) treated with chemotherapy for manifest lung metastases, and in one of eight patients (13%) who received adjuvant chemotherapy, but in whom lung metastases developed later. Pneumothorax did not develop in 79 patients treated with chemotherapy for disseminated testicular cancer, despite the fact that 82% of these patients had manifest lung metastases.

Adolescent↗