pneumothorax
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pneumothoraxTRANSCRIPT
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Spontaneous Pneumothorax
By: Dr. IsmahReference: Management of spontaneous pneumothorax,
British Thoracic Society pleural disease guideline 2010
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Suction• Not routinely used because may cause re expansion
pulmonary edema• Indicated when persistent air leak with or without incomplete
re-expansion of the lung after 48 hrs• High-volume low-pressure systems such as Vernon-Thompson
pumps or wall suction with low pressure adaptors
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Bronchopleural fistula• Communication between the bronchial tree and pleural space.• Persistent air leak or a failure to re-inflate the lung despite
chest tube drainage for 24 h.• Chest drains inserted into the lung parenchyma• Management: - Large bore chest drains (multiple if necessary) and the use of
drainage system- Refractory cases surgical repair of the air leak by
thoracoplasty, lung resection/stapling, pleural abrasion/decortication
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Thoracic surgeon
Indications for surgical advice: • Persistent air leak (despite 5 to 7 days of chest tube drainage)
or failure of lung re-expansion.• Synchronous bilateral spontaneous pneumothorax.• Professions at risk (eg, pilots, divers).• Pregnancy.• Second ipsilateral pneumothorax.• First contralateral pneumothorax.• Spontaneous haemothorax
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Advice & f/up• Avoid air travel until 1 weeks post fully resolution• Avoid diving unless has undergone bilateral surgical
pleurectomy and has normal lung function and chest CT scan postoperatively
• Observation/ NA F/up in 2-4 weeks
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THANK YOU 11
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Tension Pneumothorax
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