How is collapsed lung treated?
The treatment will depend on the underlying cause, the size of the pneumothorax and the severity of the condition.
- Observation: If the pneumothorax is very small and there are no symptoms, the lung may re-inflate on its own. The patient should be observed closely for signs of respiratory or cardiac problems and schedule follow-up visits with a healthcare provider.
- Supplemental oxygen: If the pneumothorax is very small, the patient may only require supplemental oxygen. Patients should be observed to see whether their condition remains stable. Additional chest X-rays might be taken during that period.
- Needle aspiration: A needle attached to a syringe is inserted into the chest cavity to remove air via suction.
- Percutaneous chest tube drainage: If the pneumothorax is large or if the patient has trouble breathing, a small plastic tube may be inserted into the pleural space to remove air. The collapsed lung will reinflate as the pressure on the lung decreases. Ultrasound or other imaging methods may be used to guide the placement of the chest tube.
- Open chest thoracotomy: An incision is made to allow insertion of a small-bore catheter or chest tube to remove air under suction pressure.
- Video-assisted thoracoscopic surgery (VATS): This is a minimally invasive procedure in which a tiny fiber-optic camera (thorascope) and surgical instruments are inserted through one or more small incisions. The camera displays video images on a monitor while the surgeon removes lung tissue.
- Chemical pleurodesis: This procedure involves introducing a chemical irritant into the pleural space in order to attach the outside of the lung to the chest cavity. It is performed to prevent the lung from collapsing again.
- Mechanical pleurodesis: This procedure is similar to chemical pleurodesis, except it is performed by a surgeon who uses a piece of dry gauze to roughen the pleural membrane.
If these methods are not effective or if collapsed lung recurs, surgical treatment may be needed. Patients with traumatic lung injuries or secondary spontaneous pneumothorax may be candidates for surgery. Indications that surgery may be required include
- Persistent air leakage for more than 1 week.
- Pneumothorax in both lungs.
- Recurrent pneumothorax.