The difference between tension pneumothorax and open pneumothorax.

Written by Zhang Zhi Gong

Cardiothoracic Surgery

Updated on December 12, 2024

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The main difference between a tension pneumothorax and an open pneumothorax lies in the relative pressures of the pleural cavity compared to the atmospheric pressure. An open pneumothorax occurs when the pleural cavity is in an open state due to some reason. During inhalation, gas can enter the pleural cavity, and during exhalation, the gas can be expelled through this opening or another opening, resulting in pleural cavity pressure that is roughly equal to the atmospheric pressure. In a tension pneumothorax, due to some reason, a one-way valve is formed. The gas enters the pleural cavity easily but encounters resistance during expulsion, causing the pressure in the patient's pleural cavity to increase progressively. The gas can only enter the pleural cavity and cannot be effectively expelled. Therefore, the main difference between a tension pneumothorax and an open pneumothorax is the level of pleural cavity pressure compared to atmospheric pressure; in a tension pneumothorax, the pressure in the pleural cavity is significantly higher than the atmospheric pressure, while in an open pneumothorax, the pressures are roughly equal.

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Written by Wang Chun Mei

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Can pneumothorax measure lung capacity?

Pneumothorax is a very common type of disease, caused by many and complex factors. It is classified into three different types based on individual conditions, so different types of pneumothorax lead to different clinical symptoms and consequences for the patient. Usually, it is not advisable to measure lung capacity immediately after a pneumothorax occurs. For lighter cases, it is recommended to wait at least half a month before measuring lung capacity. If the pneumothorax is severe, the interval may need to be over a month before conducting lung capacity measurements. Therefore, while patients with pneumothorax can have their lung capacity measured, this should only be done once the condition is effectively managed.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 12sec

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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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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 12sec

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Pneumothorax is more likely to recur in which season?

Regarding the seasonal issue of pneumothorax recurrence, the causes of pneumothorax vary among patients of different ages, so the seasons prone to recurrence are also not exactly the same. For young patients, pneumothorax tends to recur easily, often in thin and tall patients, usually related to recent colds and coughs, or intense physical activities like basketball, soccer, or seasons with more outdoor activities; these times are relatively more prone to recurrence. Particularly, the cooler seasons of spring and fall are also prone to recurrences. However, for elderly patients, the causes of pneumothorax recurrence are usually associated with smoking in older patients, or a history of chronic obstructive pulmonary disease and bullae. For these elderly patients, recurrences typically occur in the autumn and winter seasons. This is because the autumn and winter seasons are comparatively more problematic for patients with chronic bronchitis and obstructive lung diseases. Thus, pneumothorax recurrence in young people often happens more in the spring and autumn, while in older people, it occurs more in the autumn and winter seasons.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 15sec

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How many days after pneumothorax can one smoke?

For patients with pneumothorax, it is advised to strictly quit smoking, as smoking greatly increases the recurrence of pneumothorax. Smoking leads to airway inflammation and respiratory bronchitis. Among male patients with pneumothorax, compared to non-smokers, smokers have a significantly higher incidence of pneumothorax, which is related to the degree of smoking. If the patient smokes less than half a pack, the recurrence rate of his pneumothorax is about 7 times higher. For moderate smokers, those who smoke between half a pack and one pack, the recurrence rate increases to 21 times. If one smokes a pack a day, the recurrence rate rises to 102 times, this is in males. In females, for those smoking less than half a pack, between half a pack and one pack, and more than one pack, the recurrence rates of pneumothorax become 4 times, 14 times, and 68 times respectively. Therefore, for both male and female patients with pneumothorax, smoking significantly increases the probability of recurrence. So, once pneumothorax is resolved, quit smoking as well, to prevent any future recurrences.