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Treatments and drugs
By Mayo Clinic staffThe goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to re-expand, and to prevent recurrences. The best method for achieving this depends on the severity of the lung collapse and sometimes on your overall health:
- Observation. If your lung is less than 20 percent collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the air is completely absorbed and your lung has re-expanded. Because it may take weeks for a pneumothorax to heal on its own, however, a needle or chest tube may be used to remove the air, even when the pneumothorax is small and nonthreatening.
- Needle or chest tube insertion. When your lung has collapsed more than 20 percent, your doctor is likely to remove the air by inserting a needle or hollow tube (chest tube) into the space between your lungs and your chest wall. Chest tubes are often attached to a suction device that continuously removes air from the chest cavity and may be left in place for several hours to several days.
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Other pneumothorax treatments. If you have had more than one pneumothorax, you may have treatments to prevent further recurrences.
A common surgical procedure is called video-assisted thoracoscopy, which uses small incisions and a tiny video camera to guide the surgery. In this procedure, two or three tubes are placed between your ribs while you're under general anesthesia. Through one of the tubes, the surgeon can observe with a fiberscope, while through the other tube, the surgeon attempts to close the air leak with surgical instruments. Rarely, when this doesn't work, a surgical procedure with an incision is necessary.
The chest tube remains in as long as necessary until the air in the pleural space is gone and doesn't recur when the chest tube is clamped and checked with an X-ray. Video-assisted thoracoscopy leads to less pain and a shorter recovery time than other types of surgery do because the chest cavity can be accessed without breaking any ribs.
- Pneumothorax. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec05/ch060/ch060g.html. Accessed Feb. 17, 2009.
- What are pleurisy and other disorders of the pleura? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/pleurisy/pleurisy_all.html. Accessed Feb. 17, 2009.
- Smith DA. Pulmonary emergencies. In: Stone CK, et al. Current Diagnosis & Treatment: Emergency Medicine. 6th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3106264. Accessed Feb. 17, 2009.
- Noppen M, et al. Music: A new cause of primary spontaneous pneumothorax. Thorax. 2004;59:722.
- Light RW. Disorders of the pleura and mediastinum. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2861952. Accessed Feb. 17, 2009.
- Light RW. Primary spontaneous pneumothorax in adults. http://www.uptodate.com/home/index.html. Accessed Feb. 17, 2009.
- Spontaneous pneumothorax fact sheet. American Lung Association. http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35772. Accessed Feb. 17, 2009.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 24, 2009.
