Collapsed Lung (Pneumothorax)
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What is a collapsed lung?
A collapsed lung occurs when air enters the pleural space, the area between the chest wall and the lung. Air in the pleural space can build up and press against the lung, causing it to collapse partially or fully. Also called a deflated lung or pneumothorax, a collapsed lung needs immediate medical care.
What are the different types of collapsed lung?
There are five main types of collapsed lung:
- Primary spontaneous pneumothorax: Collapsed lung sometimes happens in people who don’t have other lung problems. It can occur due to abnormal air sacs in the lungs that break apart and release air.
- Secondary spontaneous pneumothorax: Several lung diseases may cause a collapsed lung. These include chronic obstructive pulmonary disease (COPD), cystic fibrosis and emphysema.
- Injury-related pneumothorax: Injury to the chest can cause collapsed lung. Some people experience a collapsed lung due to a fractured rib, a hard hit to the chest or a knife or gunshot wound.
- Iatrogenic pneumothorax: After certain medical procedures such as lung biopsy or a central venous line insertion, some people can have complications that include a pneumothorax.
- Catamenial pneumothorax: This rare condition affects women who have endometriosis. Endometrial tissue lines the uterus. With endometriosis, it grows outside the uterus and attaches to an area inside the chest. The endometrial tissue forms cysts that bleed into the pleural space, causing the lung to collapse.
Symptoms and Causes
What causes a collapsed lung?
Pneumothorax has three main causes: medical conditions, injuries and lifestyle factors.
Medical conditions that may cause a collapsed lung include:
- Chronic obstructive pulmonary disease (COPD).
- Collagen vascular disease.
- Cystic fibrosis.
- Endometriosis in the chest.
- Idiopathic pulmonary fibrosis.
- Lung cancer.
- Marfan syndrome.
- Acute respiratory distress syndrome (ARDS), a condition caused by pneumonia, coronavirus and other illnesses.
Injuries that may cause collapsed lung are:
- Blunt force trauma.
- Certain types of ventilation or changes to ventilation.
- Gunshot wound.
- Lung puncture during a medical procedure, like a biopsy or nerve block.
- Stab wound.
Lifestyle factors associated with collapsed lung are:
- Drug use, especially inhaled drugs.
- Flying that involves drastic changes in air pressure.
- Scuba or deep-sea diving.
People with certain other risk factors may be more likely to have a collapsed lung. These are:
- Family history of pneumothorax.
- Tall, thin body type.
What are the symptoms of collapsed lung?
A collapsed lung can have many signs and symptoms. If you have symptoms of a collapsed lung, go to the emergency room. You may need immediate care.
Signs of a collapsed lung include:
- Chest pain on one side especially when taking breaths.
- Fast breathing.
- Fast heart rate.
- Shortness of breath.
- Skin that appears blue.
Diagnosis and Tests
How is a collapsed lung diagnosed?
Your healthcare provider will ask about your history of lung disease and perform a physical exam. They may also measure the level of certain gases in your bloodstream. To measure gases like oxygen and carbon dioxide, a technician collects a blood sample and analyzes it in a lab.
The most common way to diagnose a collapsed lung is with medical imaging. Usually, you’ll have a chest X-ray. But you may have a CT scan or ultrasound.
Management and Treatment
How is collapsed lung treated?
Your treatment depends on the cause, size and severity of your pneumothorax. Collapsed lung treatment may include:
Observation: If your pneumothorax is minor, your provider may watch you for signs of heart or breathing problems. You will see your provider for a follow-up visit.
Supplemental oxygen: Your provider may give you extra oxygen if your pneumothorax is small but you have symptoms. Your provider watches to make sure your condition is stable.
Needle aspiration: During aspiration, a provider uses a syringe to remove some of the air in the pleural space. A provider may follow needle aspiration with percutaneous chest tube drainage.
Chest tube drainage: If you have a larger pneumothorax, your provider may put a hollow tube in your chest to reduce the air in the pleural space. As the air pressure decreases, the lung re-expands and heals. You may have this tube in place for a couple of days or longer.
Chemical pleurodesis: To prevent the lung from collapsing again, a provider may perform pleurodesis. Your provider makes an incision and inserts a tube. Then your provider uses chemicals (such as doxycycline or talc) to attach the lung to the chest cavity, eliminating extra space in the chest cavity.
Surgery: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure that uses a small camera to help the surgeon remove lung tissue. Your surgeon may also perform a chemical pleurodesis or a mechanical pleurodesis using a piece of gauze to attach the lung to the chest cavity. You may be a candidate for surgery if you don’t respond to other treatment or have:
- Persistent air leakage from chest tube.
- Lung that does not expand despite chest tube insertion.
- Recurrent collapse lung.
- Pneumothorax in both lungs.
- Traumatic lung injuries.
What are the complications of a collapsed lung?
Although most collapsed lungs heal without problems, serious complications do occur. These can include:
- Re-expansion pulmonary edema, when extra fluid is in the lungs.
- Damage or infection caused by the treatment.
- Inability to breathe.
- Heart failure.
Can I prevent a collapsed lung?
If you have certain medical conditions or a family history of pneumothorax, you might not be able to prevent a collapsed lung.
Anyone can take steps to reduce your chances of collapsed lung:
- Stop smoking.
- Avoid or limit activities with drastic changes in air pressure (scuba diving and flying). Follow your provider’s recommendations if you do these activities.
- See your provider regularly to monitor any lung conditions.
Outlook / Prognosis
What is the outlook for collapsed lung?
Most people who have a collapsed lung generally heal without major treatment. If you’ve had a collapsed lung, you have a higher chance of having it again.
What can I expect after treatment for a collapsed lung?
After treatment, you may be in the hospital for a couple of days or longer. This allows your provider to check your progress and give you oxygen, if necessary.
You will make an appointment for follow-up visits. You should contact your provider if symptoms of collapsed lung return.
Your provider will also recommend avoiding:
- Air travel for two weeks.
- Scuba or deep-sea diving, possibly permanently.
What should I ask my healthcare provider?
If you have a collapsed lung, ask your provider:
- What caused my collapsed lung?
- Is there anything I can do to prevent another collapsed lung?
- Do I need treatment for my collapsed lung?
- If I need to have a chest tube, how long will I have it?
- Will I need extra oxygen?
- Will I need to stay in the hospital?
- What kind of care will I need after treatment?
- What kind of care will I need after I leave the hospital or clinic?
- What should I avoid doing after my treatment?
A note from Cleveland Clinic
A collapsed lung is rare, but it can be serious. If you have signs or symptoms of a collapsed lung, such as chest pain or trouble breathing, get medical care right away. Your lung may be able to heal on its own, or you may need treatment to save your life. Your provider can determine the best form of treatment for you.
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