tension pneumothorax


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Related to tension pneumothorax: flail chest, open pneumothorax

ten·sion pneu·mo·thor·ax

a pneumothorax in which air enters the pleural cavity and is trapped during expiration; intrathoracic pressure builds to levels higher than atmospheric pressure, compresses the lung, and may displace the mediastinum and its structures toward the opposite side, with consequent cardiopulmonary impairment.

tension pneumothorax

Etymology: L, tendere, to stretch; Gk, pneuma, air, thorax
the presence of air in the pleural space when pleural pressure exceeds alveolar pressure, caused by a rupture through the chest wall or lung parenchyma associated with the valvular opening. Air passes through the valve during coughing but cannot escape on exhalation. Unrelieved pneumothorax can lead to respiratory arrest.

tension pneumothorax

A life-threatening emergency caused by air under pressure in the pleural space due to a one-way valve mechanism, which allows increased entry of air and eventually complete lung collapse on the affected side, accompanied by mediastinal shift of thoracic organs (heart, trachea, oesophagus) and great vessels towards the unaffected side of the chest, and compression of the opposite lung with compromise in the return flow of blood to the heart.
 
Aetiology
Penetrating trauma to the chest, infection, mechanical ventilation with high pressures, and as a complication of CPR.
 
Management
Chest tube drainage, or pleurodesis.

tension pneumothorax

Critical care A life-threatening emergency consisting of air under pressure in the pleural space, due to a one-way valve type mechanism, allowing ↑ entry of air and eventually complete lung collapse on the affected side, which is acompanied by mediastinal shift of thoracic organs–heart, trachea, esophagus, and great vessels towards the unaffected side of the chest, and compression of the opposite lung with compromise in the return flow of blood to the heart Etiology Penetrating trauma to the chest, infection, mechanical ventilation with high pressures, and as a complication of CPR Management Chest tube drainage, or pleurodesis. See Pneumothorax.

pneumothorax

entry of air into the pleural cavity in sufficient quantity to cause collapse of the lung and consequent respiratory embarrassment. If it is unilateral there is a mediastinal shift with displacement of the heart to the other side of the chest. Breath sounds are absent from the affected side.
Enlarge picture
Pneumothorax. By permission from Ettinger SJ, Feldman E, Textbook of Veterinary Internal Medicine, Saunders, 2004

closed pneumothorax
air leaks from a discontinuity in the lung into the pleural cavity.
false pneumothorax
artifactual increased radiolucency of the thorax resembling free air in the pleural cavity.
iatrogenic pneumothorax
may occur following intrathoracic surgery or in association with procedures which involve entry into the pleural cavity, such as thoracentesis or placement of a chest drain.
open pneumothorax
caused by an open wound in the chest wall.
spontaneous pneumothorax
due to an unknown cause.
tension pneumothorax
a particularly dangerous form of pneumothorax that occurs when air escapes into the pleural cavity from a bronchus but cannot regain entry into the bronchus. As a result, continuously increasing air pressure in the pleural cavity causes progressive collapse of the lung tissue. If not relieved, it can lead to lung collapse and mediastinal shift.
References in periodicals archive ?
After review of the literature, the investigators developed the CP instrument relative to the care of patients with battlefield injuries, specifically tension pneumothorax, cardiac tamponade, and hypovolemic shock.
I had never heard of it before, but now I know how to stick a needle into someone's chest cavity," said SPC Charles Romito, after learning how to relieve a tension pneumothorax during the course.
2] jet ventilation delivered via the lumen of the catheter can result in barotrauma and tension pneumothorax.
Many paramedics had not been trained how to diagnose a potentially life-threatening condition known as tension pneumothorax.
A baby in the oximeter group whose blood pH measurements at 5 and 10 minutes were normal died of an unrecognized tension pneumothorax.
Hypotension and reduced cardiac output can occur much like a cardiac tamponade or tension pneumothorax.
In 25 patients there was delayed clinical recognition of a tension pneumothorax (TPTX).
Atrial Fibrillation and Atrial Flutter, Pneumothorax, Laryngoscope, SVT, Tension Pneumothorax, ETT, Hydropneumothorax, liver biopsy needle, Introduction to Ischemic changes on ECG, Consolidation and venture mask, T Wave inversions, ST segment depression, subcutaneous emphysema, oropharyngeal airway, St segment Elevation, Pericarditis ECG, Hilar Lymphadenopathy Unilateral and Bilateral, Indications of Adrenaline, Introduction to Hypertrophy of cardiac chambers, Indications of Atropine, Left Atrial Hypertrophy, Mediastinal widening, indications of steroids,
Serious complication such as tension pneumomediastinum with tension pneumothorax can occur but are very rare.
As capnothorax was known to resolve spontaneously in the post-operative period and as there were no signs of tension pneumothorax (bradycardia, hypotension, tracheal or mediastinal shift in chest x-ray), we decided to opt for conservative management.
However, when hemodynamic stability occurs during the intraoperative crisis, management with tension pneumothorax should not be delayed waiting for a radiographic confirmation.