Tension Pneumo-Thorax

Tension Pneumo-Thorax

Introduction

Tension pneumothorax occurs when a valve mechanism at the level of the chest wound allows air to enter the pleural space but prevents its output. In the case of blunt trauma, a fractured rib punctures the lung parenchyma and air occupying the pleural cavity has no escape mechanism, when the trauma is pervasive, the hole is opened during inspiration and closes during expiration, so which produces a valve mechanism which retains in air into the pleural cavity. Increased pressure within the pleural cavity completely collapsed lung and the hemithorax ventilation committed unaffected, since children in the mediastinum is mobile, the air pressure causes mediastinal shift, decreased preload and a substantial drop cardiac output.

Discussion

Pathophysiology

Air can enter the pleural cavity from:

The lung parenchyma

The tracheobronchial tree

Esophagus

Intra-abdominal organs

The outside through the chest wall

May sometimes be caused by a combination of these sources

Physiopathological changes resulting pneumothorax depends on the amount of air in the pleural cavity and the state of the patient's cardiopulmonary function.

The accumulated air in the pleural cavity causes compression of the lung to JOINING positive intrapleural pressure, compromising gas exchange. This can be quite severe in a patient with underlying lung disease, lung collapse but not great. When the whole lung collapse Pneumothorax occurs and persists air intake, the mediastinum shifts to the opposite side decreased functional residual capacity of the other lung, compressing large venous vessels in addition to altering the venous return and producing a hemodynamic shock, as well respiratory failure.

They are important air leaks from lung parenchyma and tracheo-bronchial tree by its ability to cause tension pneumothorax. This type of pneumothorax endangers the patient's life and should be handled immediately, evacuating air from the pleural cavity. It is characterized by severe dyspnea, absent breath sounds and tympany on the affected side with the patient hypotensive and trachea deviated to the contra-lateral side

Causes, Incidence, and Risk Factors

Every situation that causes pneumothorax can lead to a tension pneumothorax. In unsophisticated pneumothorax, air can effortlessly come into and go out of the pleural liberty, but in tension pneumothorax, air goes through the pleural breathing space with every inhalation and becomes ensnared there.

Since the quantity of rapt air augments, the heaviness in the chest, the lung crumples on that side and can move forward the imperative organizations in the middle of the trunk (like the great vessels, airways and heart) in the direction of the from corner to corner in the upper body. The move can lead to compression of lung, and can influence flow of blood recurring to the heart.This state of affairs can make possible low pressure of blood, distress and passing away.

Symptoms of this disease may include;

Sudden pain in chest

Breathlessness

Tightness of chest

Exhaustion

The skin color turns to blue due to inadequate oxygen

Fast rate of cardiac activity

Low pressure of blood

Reduced attentiveness

Diminished perception

Fast inhalation

Distended and full to bursting veins of neck



Clinical Presentation

Most episodes occur Primary spontaneous pneumothorax (NEP) when the person is at rest ipsilateral pleuritic pain occurs with or without ...