Atelectasis and Pneumothorax - Get your breath back

X-ray of a collapsed lung (specifically a pneumothorax) The darker area you see on the left is air which has escaped the lung and is now trapped in the thoracic cavity.
X-ray of a collapsed lung (specifically a pneumothorax) The darker area you see on the left is air which has escaped the lung and is now trapped in the thoracic cavity.

What is a Pneumothorax, or Atelectasis?

A pneumothorax, as well as atelectasis, is a collapsed lung - with one primary difference. A pneumothorax involves puncture of the pleural lining of the lung, releasing air into the chest cavity. Atelectasis is simply a collapsed lung which is unable to expand. Once a lung has collapsed, the other lung will compensate for the time being. However, both of these conditions are potentially life threatening, considering we cannot live without oxygen in our bloodstream.

Causes and Risk Factors

Usually a pneumothorax results from some sort of trauma - like getting shot/stabbed, or breaking a rib. The punctured lung will release air into the chest, causing the pneumothorax. Sometimes a pneumothorax can occur spontaneously though, because part of the lung ruptured. This happens more frequently in people with lung diseases such as COPD (chronic bronchitis and emphysema), tuberculosis, asthma, pertussis, and cystic fibrosis. Other risk factors include smoking, being tall and thin, or having a past history of collapsed lungs.

Atelectasis does not result from a puncture wound, but rather a blockage of the airway. Occasionally it can result from pressure to the outside of the lung as well (like if you were scuba diving under high water pressure). Things that could potentially obstruct the airway include mucus, tumors, or small objects - so if you have little ones, don't let them aspirate their toys.

A blockage can cause atelectasis, which prevents the lung from expanding.
A blockage can cause atelectasis, which prevents the lung from expanding.

Symptoms

A Pneumothorax/Atelectasis can vary widely in severity. More often than not, you will want to seek immediate medical attention. The following symptoms can alert you to the problem promptly:

Dyspnea (difficulty breathing)

A weak cough

Shortness of Breath

Chest Pain and Tightness

Symptoms of Shock

Cyanosis (a bluing of the extremities due to a lack of oxygen)

Fatigue and Syncope (fainting)

Low blood pressure

Tachycardia (high heart rate)

If proper breathing is not restored, the lack of oxygen can eventually lead to brain damage, or even death - so get to a hospital!


Tests and Treatments

A variety of tests and treatments will need to be performed once a patient gets to the hospital. Doctors will auscultate the lung to check for breathing sounds. Decreased or absent noise can indicate a collapsed lung. Sometimes patients with seriously compromised breathing require intubation, or even ventilators for a time. X-rays and CT scans can diagnose the problem.

Once a collapsed lung is suspected, the healthcare team may choose to puncture the chest to drain out the air (in the case of a pneumothorax). Sometimes surgery is required to repair the damage.

On the flip side of all that, a small pneumothorax may not require treatment at all - for instance someone with lung disease may have a small rupture that doesn't compromise breathing.

During recovery, oxygen therapy can help restore proper lung function over time. Breathing therapy including incentive spirometry is often necessary to restore full breathing function. Regular exercise can promote good circulation and healthy lung function. Because a person recovering from a collapsed lung is at a higher risk for developing pneumonia, precautions are usually taken to prevent it. Sometimes an antibiotic may be prescribed.

The danger of a pneumothorax, or atelectasis, depends greatly on how fast medical attention is brought to the injury. If you suspect a collapsed lung in yourself or someone else, you could save a life.


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