Tension pneumothorax

Alternative Names

Pneumothorax - tension

Treatment

If you have symptoms of tension pneumothorax, get immediate medical treatment.

Treatment removes the air from the pleural space, allowing the lung to re-expand. In an emergency, a small needle (such as a standard intravenous needle) may be placed into the chest cavity through the ribs to relieve pressure.

The standard treatment is a chest tube, a large plastic tube that is inserted through the chest wall between the ribs to remove the air. The chest tube is attached to a vacuum bottle that slowly removes air from the chest cavity. This allows the lung to re-expand. As the lung heals and stops leaking air, the vacuum is turned down and then the chest tube is removed. Some people might need to stay in the hospital to have the chest tube checked, and because it can take several days for the affected lung to fully re-expand.

Surgery may be needed if the problem happens again, or if the lung does not re-expand after 5 days with a chest tube in place.

Outlook (Prognosis)

Up to 50% of patients who have a pneumothorax will have another. There are no long-term complications after successful treatment.

Possible Complications

• Acute respiratory failure
• Air in the mediastinal space, which can interfere with heart and lung function (pneumomediastinum)
• Very low blood pressure (shock)
• Death

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of this disorder.

References

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000. 

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.