Pneumothorax occurs when air gets into the pleural space between the two layers, and separates them. Majority of the time only part of the lung collapses, except for in severe cases the whole lung can collapse, therefore it is emptied of air. The types of pneumothorax being discussed are primary spontaneous pneumothorax, secondary traumatic pneumothorax, iatrogenic pneumothorax, and open or tension pneumothorax. Along with the discussion of the pathophysiology, the topics such as diagnostic tests and primary diagnosis, pharmacological interventions, vulnerable groups, and the nursing diagnosis are also examined.
Pathophysiology
Primary spontaneous pneumothorax, occurs unexpectedly in healthy people, and it is often caused by the rupture of blebs which are blister-like formations, on the visceral pleura. Around ten percent of people affected with this have a family history of primary pneumothorax that was linked to mutations in the folliculin gene which influences cell-cell adhesion, (Huether & McCance, 1254). Bleb rupture can occur during rest, sleep, or even exercise. Secondary traumatic pneumothorax can be caused by chest trauma such as a gun shot wound, stab wound, surgery, or rib fracture. Iatrogenic pneumothorax is usually caused by transthoracic needle aspiration. Symptoms of iatrogenic pneumothorax are similar to those of a spontaneous pneumothorax and depend on the age of the patient, the presence of underlying lung disease, and the extent of the pneumothorax,
A.B. admitting diagnosis pleural effusion, pulmonary infiltrates possible pneumonia based on the result of chest x-ray. Also the presenting signs and symptom provided information that can link to pleural effusion evidenced of his signs and symptoms
Hemothorax is a type of pleural effusion in which blood accumulates in the pleural space. The excess fluid can interfere with normal breathing by limiting expansion of the lungs.
Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.
Pt received AP diameter X-ray to confirm tube placement and to see if there were any kind of infiltrates because of possible aspiration and to eliminate possible pneumothorax and pleural effusion. Findings included mild patchy infiltrates in the right upper to middle lobes. The left lower lobe also has some similar findings but less concerning. This may either be due to lung infection or pulmonary
A hemothorax is a collection of blood in the space between the chest wall and the lung. The medical term for this space is the pleural cavity. It is also called the pleural space. The most common cause for this condition is a chest injury. It can also happen from:
During inhalation the air sacs pull in oxygen and during exhalation the air sacs let out carbon dioxide. This gas exchange should happen without complication but with pulmonary edema fluid fills up in the alveoli in place of air, averting the bloodstream from absorbing oxygen. Pulmonary edema usually requires a hospital stay of a few days or longer. Patients are seen by several specialists during their hospital stay. Once the condition is controlled, outpatient treatment with a cardiologist or a pulmonologist is recommended (Mayo Clinic
A tension pneumothorax occurs when the lung is punctured, but there is no outside opening for air to escape. The pressure that builds is put on internal organs, which decreases cardiac output and the lungs’
In 1974 Ward reported an incidence of 3% of symptomatic pneumothorax after ISB by paraesthesia blind technique. The pneumothorax was almost certainly produced by the prior attempt to carry out a supraclavicular block, as it is difficult to imagine the apex of the lung reaching as high as C6, the level of an
Pleural effusions definite as accumulation of fluid between two membranes the inner layer (visceral) and the parietal the outer layer (parietal). This space has usually an extremely little quantity of fluid about10 – 20 ml to provide lubrication between this two layers. Pleural effusion is a considerable problem subsequent pediatric cardiac surgery with a description occurrence of above 25%.1,2 It led to major morbidity subsequent pediatric cardiac surgery and increases intensive care unit (ICU) stay and hospitalization. Pleural effusion is principally frequent following uni-ventricular surgery (palliation operation) .3Pleural effusions in after cardiac surgery may present into a multiplicity of customs. In many period, these patients may be entirely asymptomatic and pleural effusion is an incidental diagnosis on chest x-ray (CXR). On the other hand, may be depending on the amount of pleural effusions, these patients have been remarkable beginning of tachypnea dyspnea, breath briefness, chest pain and fever. Superior effusions may constant lead to hemodynamic instability. Therefore, rapid finding and treatment of these patients are very important.4The diagnostic methods are include, CXR is the most frequently method to investigation of large or small pleural effusions. In this technique the patients is radiation exposure and is a diagnostic method relatively
Such phenomenon would inflict pain when breathing, and evidently promote long-term suffocation. Many firefighters experience these types of symptoms when battling furious fires. The smoke and chemicals that the firefighters breathe in actually evaporate a huge portion of their surfactant. That is why in the news firefighters are reported suffering from smoke inhalation. They experience collapsed alveoli and struggle breathing. It is also important to mention the complication that come along with pneumothorax, and serious condition that involves aire between the lungs and intercostal muscles. We know that when we breathe air flows down the trachea, into the bronchi, and spread throughout the lungs. However, what happens when there is a hole punctures in one of the pathways for air. This phenomenon would cause air to accumulate in the chest, instead of going into the lungs. We expand our chest to increase volume, and decrease the pressure inside. Because atmospheric pressure is exceedingly higher that it is in the lungs, air will flow from high pressure to low pressure. This phenomenon cannot happen with
Airway Pressure Release Ventilation (APRV) is an unconventional pressure controlled mode of ventilation that use inverse ratio strategy. Moreover, APRV based on the principle of open-lung approach, and it is a lung protective strategy mode. Therefore, one of the primary goals of APRV is to decrease the incident of Ventilator-induced lung injuries (VILI). Another purpose of APRV is that APRV aims to recruit the lung as well as to improve oxygenation. To illustrate, APRV creates continuous sequences of positive airway pressure that would significantly increase the mean airway pressure (Paw) which would lead to Lung recruitment and improve oxygenation. Furthermore, APRV helps to decrease the inflation/deflation process which contributes in avoiding alveolar derecruitment. In a similar way, APRV applies pressure to sustain FRC for alveolar recruitment. Finally, APRV helps patient to eliminate CO2 efficiently. On APRV, CO2 is washed during the release phase, and during spontaneous breathing as patients on APRV are allowed to breathe spontaneously at any time at the respiratory cycle on APRV. In Summary, The primary goals of Airway Pressure Release Ventilation are to minimize Ventilator-induced lung injuries cases, help to recruit lungs, improve oxygenation, avoid alveolar derecruitment, and eliminate CO2 efficiently.
Bronchopulmonary dysplasia due to the use of ventilators. Ventilators disturb the normal growth of the lungs.
Another factor that can cause pulmonary edema is trauma to the lungs. This includes near drowning experiences, drug abuse, inhaling smoke that contains certain chemicals, and injury or trauma to the brain or nervous system. These injuries or traumas can affect your lungs in such serious ways, that this disease can be deadly.
Pneumomediastinum is a pathologic condition characterized by the presence of air within the mediastinum and within deep neck spaces. It can be further categorized as spontaneous pneumomediastinum or secondary pneumomediastinum. Spontaneous pneumomediastinum is a rare clinical entity seen without any precipitating factors. On the other hand, secondary pneumomediastinum is due to disruption of the aeordigestive tract, typically from previous surgery, trauma, severe retching, or foreign body ingestion. Pneumomediastinum can be exacerbated by activities that generate a valsalva maneuver, as in physical exertion. The treatment protocol differs substantially between these two entities, so it is crucial that physicians differentiate between the two by gathering the appropriate history and physical exam. We report a case of a healthy 44 year old male who developed pneumomediastinum with moderate head and neck subcutaneous emphysema after minimal trauma while boogie boarding. The patient remained asymptomatic except for mild dysphonia and head and neck swelling. An extensive PubMed search revealed several case reports of spontaneous pneumomediastinum. This is, however, to our knowledge, one of the few reports of moderate to severe spontaneous pneumomediastinum presenting relatively asymptomatically. With this case report we hope to add to the current body of literature and present an unusual presentation of spontaneous pneumomediastinum in a healthy individual.
One of these is pneumothorax, or collapsed lung. This can occur if the cysts rupture through the lining of an affected lung. The air that collects in the space between the lung and chest wall must be removed in order for the lung to be reinflated. Pleural effusions may also occur. This is where bodily fluids collect in the space between the lung and chest wall, and it can often cause shortness of breath due to the restricted room to expand. Many later sym