ISSN 2398-2969      

Tension pneumothorax

icanis
Contributor(s):

Daniel Smeak


Introduction

  • Cause: valve-like tear in lung surface, small airway, thoracic wall or, rarely, esophagus.
  • Air enters pleural space during inspiration and unable to escape during expiration.
  • Signs: progressive dyspnea, rapid, shallow breathing.
  • Treatment: immediate evacuation of pleural space with thoracocentesis and oxygen supplementation.
  • Once stabilized, the cause must be established and repaired or resected surgically if condition persists, or primary lesions are identified that are causing air leakage, eg rupture lung abscess.
  • Diagnosis: signs, radiography.
  • Prognosis: rapidly fatal if untreated.

Pathogenesis

Etiology

  • Traumatic defect in pulmonary tissue, airway, chest wall or, rarely, esophagus.

Pathophysiology

  • Air enters the pleural space during inspiration and cannot escape during expiration. Therefore, intrapleural pressure builds up with successive respiratory cycles, the pressure rapidly exceeding atmospheric pressure.
  • Lung collapse → ventilation/perfusion mismatch.
  • Such a pressure increase reduces ventilation and venous return to the heart.
  • Death will occur due to cardio-pulmonary collapse, with hypoxia and reduced cardiac output.

Timecourse

  • Peracute.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Valentine A K & Smeak D D (2000)Pneumothorax in the dog. In:Current Veterinary Therapy XIIIEd J Bonagura. Philadelphia: W B Saunders Co. pp 825-827.

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