Pneumothorax


Can you smoke with pneumothorax?
After suffering from pneumothorax, patients often experience symptoms such as chest pain, chest tightness, and coughing. Can patients smoke after suffering from pneumothorax? It is advised against smoking after suffering from pneumothorax, as smoke and harmful substances directly irritate the respiratory tract, worsening the patient's symptoms. Additionally, smoking produces a large amount of carbon monoxide, which, when absorbed by the body, can cause hypoxia, thereby exacerbating symptoms of breathing difficulty. Therefore, patients with pneumothorax should not smoke, and it is also recommended to quit smoking even after recovery from pneumothorax, as smoking is harmful in many ways and particularly damaging to the respiratory system.


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.


How many days do you usually stay in the hospital for pneumothorax drainage?
This depends on whether the pneumothorax is a simple pneumothorax or is complicated by other diseases. If there are no other lung diseases present and it is just a simple pneumothorax, then typically, drainage by tube for 5 to 7 days can lead to a complete recovery and cure. However, if there are complications such as emphysema, pulmonary heart disease, pneumoconiosis, or lung infections, then it is necessary first to control the infections. During this time, the pneumothorax can easily become a communicating pneumothorax. If it lasts for more than 1 to 2 weeks, it may turn into a refractory pneumothorax. In the case of refractory pneumothorax, besides drainage, minimally invasive surgeries such as pleurodesis or pneumothorax occlusion procedures are required. These surgeries take time. Therefore, if a stubborn pneumothorax forms, especially when complications like emphysema are present, hospital stays often need to be 14 days or even longer.


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.


The difference between tension pneumothorax and open pneumothorax.
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.


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.


Can pneumothorax heal by itself?
Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity, and it is relatively common clinically. Can pneumothorax be cured after it occurs? It depends on the specific circumstances. If it is a closed pneumothorax with a small amount of air accumulation, conservative treatments like rest and oxygen therapy can allow for self-healing of the pneumothorax. However, in most cases, the accumulation of air is generally significant, and often it is a tension pneumothorax. In these instances, treatments generally involve pleural cavity puncture, or closed pleural drainage to drain the air, making it difficult to heal spontaneously and requiring medical treatment. Moreover, some patients may not recover fully despite aggressive treatment and may require surgical intervention.


Pneumothorax, which department should it go to?
Which department is better for pneumothorax treatment? There isn't a strict definition dictating which specific department one must visit for pneumothorax. Generally, you can visit the respiratory department or the cardiothoracic surgery department. If the patient's condition is very severe, then the first choice should be the emergency department, where emergency treatment can be provided before further referral.


How is pneumothorax treated?
The treatment of pneumothorax aims to promote the reexpansion of the affected lung and reduce recurrence, while considering the possibility of eliminating the cause of the disease. Treatment measures include non-surgical and surgical treatments. Non-surgical measures include observation, thoracic puncture for air evacuation, closed thoracic drainage, and pleural fixation. Surgical treatments include thoracoscopic surgery and open chest surgery. Choices should be made based on the type and frequency of occurrence of the pneumothorax, the degree of compression, the state of the condition, and the presence of complications, etc. Most patients can be cured through non-surgical treatment, while only a minority, approximately 10%-20% of patients, require surgical treatment.


Are the symptoms of pneumothorax severe?
Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity. The severity of symptoms after suffering from pneumothorax can vary, with common symptoms including coughing, chest pain, chest tightness, and difficulty breathing. The severity of symptoms largely depends on the amount of air in the pleural space. If the amount of air is small, symptoms might not be noticeable. However, with a larger amount of air, difficulty breathing can be quite severe. In cases of tension pneumothorax, the symptoms can be extremely severe and may even lead to respiratory and circulatory failure in a short period. Patients often experience significant chest tightness, restlessness, dry skin, heavy sweating, and may even lose consciousness. Immediate treatment is necessary, as there could be a risk to life.