PNEUMOTHORAX

PNEUMOTHORAX

Shintya Nanda CaritaDina Fauziah

Supervisor : dr. Ali Haedar, Sp.EM

BACKGROUNDDefinition: Pneumothorax is defined as accumulation of air in the pleural space with secondary lung collapse (Al-Qudah, 2006). Pneumothoraces can be classified according to their cause and clinical presentation: Spontaneous, traumatic, or iatrogenic (Al-Qudah, 2006). Spontaneous pneumothorax (SP) can be a medical emergency requiring early diagnosis and treatment to prevent subsequent respiratory failure and death (Saiphoklang, 2013).Spontaneous Pneumothorax clasified into 2 types: PSP and SSP The distinction between PSP and SSP should be made at the time of diagnosis to guide appropriate managementEtiology: Secondary pneumothorax develops in patients with known clinical and/or radiographic lung disease (Al-Qudah, 2006)Saiphoklang N1, Kanitsap A2. 2013. Prevalence, clinical manifestations and mortality rate in patients with spontaneous pneumothorax in Thammasat University Hospital. J Med Assoc Thai. Oct;96(10):1290-7.

Al-Qudah, Abdullah. 2006. Treatment Options of Spontaneous Pneumothorax. Indian J Chest Dis Allied Sci 2006; 48: 191-200.

Causes of secondary SP were pulmonary tuberculosis (19/34, 55.9%), chronic obstructive pulmonary disease (14/34, 41.2%), and pneumonia (8/34, 23.5%) (Saiphoklang, 2013). Mortality and Morbidity Rate: Studey in Thailand use one hundred patients with SP were identified (66 primary, 34 secondary SP), for a prevalence of 76.3 per 100,000 hospital admissions. There were 12 deaths (12%), 11 with secondary SP (Saiphoklang, 2013).The size of the pneumothorax determines the rate of resolution and is a relative indication for active intervention (BTS guideline,2010). Needle (14e16 G) aspiration (NA) is as effective as large-bore (>20 F) chest drains and may be associated with reduced hospitalisation and length of stay. (BTS guideline,2010). Following failed NA, small-bore (