5.7 : 気胸 II: 管理

The clinical symptoms of patients with a simple pneumothorax often experience sudden, sharp chest pain on the affected side that worsens with breathing or coughing.

As the pneumothorax enlarges, it restricts lung movement, leading to rapid breathing and breathlessness.

During auscultation, the affected lung may exhibit decreased or absent breath sounds due to limited or no air movement.

Severe cases can rapidly lead to respiratory distress, hypoxemia, cyanosis, hypotension, tachycardia, and profuse diaphoresis.

Managing pneumothorax involves relieving lung pressure and promoting re-expansion.

Initial management focuses on stabilizing the patient and administering high-flow oxygen to relieve hypoxia and aid in air reabsorption from the pleural space.

For moderate to large pneumothorax, a chest tube is inserted to remove air and support lung re-expansion.

During emergencies, needle aspiration is performed using a large-bore needle in the second intercostal space at the midclavicular line to remove air from the pleural space.

In persistent cases, surgical interventions like pleurodesis or video-assisted thoracoscopic surgery are performed.