Treatment of pneumothorax: Medication, puncture or surgery

Treatment depends mainly on the size and type of injury, the wound, the cause of the collapse of the lung and the general health of the individual.

In the case of a traumatic pneumothorax, treatment begins when the ambulance arrives. During transport, the patient is usually given painkillers and any open wound is treated. If cardiopulmonary insufficiency develops, resuscitation is also performed.

The mainstay of treatment is to remove the air and pressure acting on the lungs. The aim of treatment is to reexpand the lungs and restore physiological breathing and circulation.

Possible treatments:

• Conservative treatment
• Pleural puncture
• Drainage of the pleural cavity
• Extensive surgical treatment

Pleural cavity puncture is mainly performed for closed pleural defect, when suctioning the accumulated air can expand the damaged lung again.

Pleural puncture is a simpler and less invasive procedure than pleural drainage. The site of posterior puncture is primarily the intercostal space across the axillary line of the patient.

Pleural drainage is common. Pleural drainage involves removing fluid from the wound and effusion using a special tubing and pump system.

The procedure is performed under local anesthesia. Hospitalization of the patient is required. After the excess fluid is drained from the cavity and the wound is cleaned, the chest is surgically closed.

However, if drainage of the cavity is ineffective or the traumatic damage to the chest is extensive, surgery is performed. The aim of surgery is to clean the pleural cavity, restore the lung structures and repair the defect present.

If the pneumothorax is caused by minor trauma and the patient has no medical difficulty breathing, the pneumothorax may heal spontaneously in some cases.

In the case of spontaneous pneumothorax, conservative treatment is possible, especially in non-risk cases. Treatment consists of hospitalisation and constant monitoring of the patient's condition.

Pharmacotherapy and oxygen therapy are indicated - breathing therapy using an oxygen mask, which accelerates the absorption of air from the chest.

If the patient does not show signs of circulatory and respiratory instability, administration of high flow rates of 100% oxygen for one to two days of hospitalization is indicated.