Pneumothorax pleurodesis: what are the advantages and disadvantages?

Written by Han Shun Li

Pulmonology

Updated on September 03, 2024

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Pleurodesis for pneumothorax involves injecting a sclerosant into the pleural cavity to induce a sterile inflammation, causing adhesion of the parietal and visceral pleurae, thereby eliminating the pleural space. This can be used to treat pneumothorax. The benefits include a high success rate, simple operation, and low recurrence rate. The downside is that there can be adverse reactions, the most common being chest pain and fever; severe cases may cause acute respiratory distress syndrome. Therefore, extra care is needed during the pleurodesis procedure.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 11sec

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Can pneumothorax be inherited?

In fact, medicine has found that most diseases, other than traumatic ones caused by injuries or car accidents, are related to genes or heredity. For instance, diseases like diabetes and hypertension clearly have a familial hereditary history. Pneumothorax is no exception, as it also tends to cluster in certain families, or has a higher tendency than in normal families. Therefore, pneumothorax does possess a certain hereditary nature, particularly in families prone to connective tissue disorders such as Marfan Syndrome. Additionally, pneumothorax often occurs in families with mutations in the human leukocyte antigen, and in those with conditions such as homocystinuria or antitrypsin deficiency, where pneumothorax is more prevalent. Of course, there are also conditions like Marfan Syndrome and Birt-Hogg-Dube (BHD) Syndrome in these families, which also tend to develop renal cysts, renal tumors, and skin fibrofolliculomas. Thus, the more frequent occurrence of pneumothorax in these families demonstrates that pneumothorax is genetically related and has a certain degree of heredity.

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Written by Han Shun Li

Pulmonology

45sec

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Can pneumothorax recover by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural space. Patients often display symptoms such as coughing, chest pain, chest tightness, and shortness of breath. A lung radiograph can confirm the presence of a pneumothorax. Whether a patient with pneumothorax can recover on their own depends on the size of the pneumothorax. If it is a large pneumothorax, especially a communicative or tension pneumothorax, self-recovery is not possible, and treatment generally involves pleural puncture or pleural drainage tube placement. However, if the amount of air in the pneumothorax is small and the patient does not exhibit severe symptoms, then it is possible for the condition to resolve itself with bed rest.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 33sec

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How many days does it take for a pneumothorax to heal?

The healing time for a patient with pneumothorax, or how many days it takes to heal, mainly depends on when the rupture on the lung heals. In younger patients who have good elasticity and strong healing capabilities, and whose nutrition keeps up, pneumothorax tends to heal relatively easily. Especially in younger patients experiencing pneumothorax for the first time, 70-80% may heal within two to three days because the gas escapes very quickly. Once the surface rupture on the lung heals, it can be cleared within a day, leading to healing. However, if the patient is older and also has conditions like tuberculosis or chronic bronchitis, the elasticity of the lungs is poorer, making healing difficult. Like a balloon without elasticity, if it gets a rupture, it may continue to expand, complicating the prediction of healing time. Regardless of age, whether the patient is young or old, if pneumothorax recurs a second time, it is advisable to seek aggressive treatment. Patients who have experienced pneumothorax twice are at more than a 70% to 80% risk of a third occurrence. This indicates a weak spot on the lung surface, similar to a wound on the hand. If a hand wound does not heal in a few days, it can be sutured. The same applies to lung surface wounds; as it is located inside the chest cavity, a thoracoscope is needed for suturing. Thus, in normal circumstances, pneumothorax could heal in a few days, but if repeatedly delayed, aggressive treatment might be necessary.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 10sec

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Pneumothorax should be seen by which department?

If it is the patient's first pneumothorax occurrence and they are relatively young with no obvious lung bullae on the surface of their lungs, then seeing the emergency department should be sufficient to resolve the issue. Generally, if less than 20% of the lung is compressed, the patient can simply breathe oxygen at home or at a community hospital to gradually recover. However, if the patient is older and the degree of pneumothorax exceeds 20%, even reaching above 30%, it is advisable to insert a small tube between one and two millimeters into the pleural cavity to extract the air. At this point, it is recommended to consult thoracic surgery. After the air is released, a CT scan is also necessary to check for obvious lung bullae or small tears on the lung surface. If a small tear is found, it is best to use minimally invasive thoracoscopy to suture or seal the tear to prevent recurrence. Therefore, if possible, directly consider consulting thoracic surgery for pneumothorax; if thoracic surgery is not available, then consider seeing the emergency department.

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Written by Xia Bao Jun

Pulmonology

51sec

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Pneumothorax is caused by what?

Pneumothorax is caused by the entry of air into the pleural cavity, leading to a series of changes. Pneumothorax can be divided into spontaneous and traumatic pneumothorax. Spontaneous pneumothorax occurs without trauma or other causes, while traumatic pneumothorax is caused by direct or indirect trauma to the pleura. Spontaneous pneumothorax can be further categorized into primary and secondary pneumothorax. Patients with primary spontaneous pneumothorax do not have underlying lung disease, whereas secondary pneumothorax is a complication of lung disease, commonly seen in chronic obstructive pulmonary disease. Traumatic pneumothorax includes iatrogenic pneumothorax, which occurs during diagnostic and therapeutic procedures.