How long after a pneumothorax can the drainage tube be removed?

Written by Han Shun Li
Pulmonology
Updated on September 12, 2024
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Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity. After the occurrence of pneumothorax, chest drainage by inserting a tube into the pleural cavity to remove the air is a common treatment. Generally, in most cases, after effective drainage for a few days, the lung can re-expand and the rupture can heal. Under these circumstances, it is common to clamp the drainage tube and observe for about two days. Then, a chest X-ray is re-examined and if there is no air, the tube can be removed. If air reappears after clamping, continued drainage is necessary. If the rupture does not heal and pneumothorax remains unresolved even after two weeks of drainage, and if the patient's physical condition allows, surgical treatment may be considered.

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Pneumothorax pleurodesis: what are the advantages and disadvantages?

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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Can pneumothorax patients take a plane?

Pneumothorax is a relatively common clinical condition, usually caused by a rupture of the pleura, allowing air to enter the pleural cavity. Patients often experience symptoms such as chest pain, difficulty breathing, and coughing. So, can someone with pneumothorax fly on an airplane? Patients with pneumothorax are prohibited from flying because the high altitude may aggravate the condition, leading to serious consequences. Even after pneumothorax has healed, it is advised not to fly within a year, as flying may cause the pneumothorax to recur.

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What position should be taken for pneumothorax?

Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity, often compressing the lung tissue. Patients may experience symptoms such as chest pain, chest tightness, and coughing. The choice of lying position for patients with pneumothorax depends on the severity of the pneumothorax and the degree of chest tightness. If the pneumothorax is mild and the symptoms are not obvious, the patient can lie flat. If there is significant chest tightness, a semi-recumbent position may be adopted. If the chest tightness is severe and the patient has significant difficulty breathing, they often assume a sitting position, frequently struggling to breathe, sweating profusely, and may even experience respiratory failure, requiring immediate attention.

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How to treat recurrent pneumothorax for the second time?

Patients with recurrent pneumothorax, we recommend proactive minimally invasive surgical intervention. For patients experiencing their first recurrence of pneumothorax, the likelihood of a second recurrence is about 20-30%. For those who have had two episodes of pneumothorax, it indicates the presence of a small rupture on the lung, or an area that has not healed well, or is particularly weak. Thus, for patients who have had two episodes or a second occurrence of pneumothorax, if they do not receive active treatment, the probability of a third recurrence rises to about 70-80%. Whether using minimally invasive surgery or the conservative method of simple tube insertion, both are certainly burdensome for the patient. However, for patients with a second occurrence of pneumothorax, undergoing a small minimally invasive surgery, which involves a small incision of one to two centimeters under the armpit to treat the pneumothorax, dramatically reduces the likelihood of subsequent occurrences from the previous 70-80% to below 10%. Therefore, the best treatment for a second pneumothorax episode is through minimally invasive surgical intervention.

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Pneumothorax recurrence symptoms

We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.