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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Written by Wang Xiang Yu
Pulmonology
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Pneumothorax should be registered under which department?

What department should you register for pneumothorax? If pneumothorax occurs suddenly, the condition is generally severe with significant breathing difficulties. In such cases, we recommend prioritizing a visit to the emergency department. Once the emergency department receives the patient, they will immediately request a consultation with a thoracic surgeon or a respiratory specialist. If the patient requires surgery, such as thoracic closed drainage or other procedures, it is usually handled by a thoracic surgeon; if the patient only requires conservative treatment, they will likely be transferred to the respiratory department; if the patient's condition is critical, they might be admitted to the ICU.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax should be seen by which department?

If it is the patient's first pneumothorax occurrence and they are relatively young with no obvious lung bullae on the surface of their lungs, then seeing the emergency department should be sufficient to resolve the issue. Generally, if less than 20% of the lung is compressed, the patient can simply breathe oxygen at home or at a community hospital to gradually recover. However, if the patient is older and the degree of pneumothorax exceeds 20%, even reaching above 30%, it is advisable to insert a small tube between one and two millimeters into the pleural cavity to extract the air. At this point, it is recommended to consult thoracic surgery. After the air is released, a CT scan is also necessary to check for obvious lung bullae or small tears on the lung surface. If a small tear is found, it is best to use minimally invasive thoracoscopy to suture or seal the tear to prevent recurrence. Therefore, if possible, directly consider consulting thoracic surgery for pneumothorax; if thoracic surgery is not available, then consider seeing the emergency department.

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Written by Xia Bao Jun
Pulmonology
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Pneumothorax tracheal shift to which side?

When a patient suffers a pneumothorax, the trachea is displaced to the opposite side, and the heart is also shifted to the opposite side. In cases of left-sided pneumothorax, the heart's dullness boundary and the upper boundary of the liver during right-sided pneumothorax are both undetectable. There can be manifestations of subcutaneous emphysema in the neck, chest, and even the head and abdomen. The patient may exhibit diminished respiratory movements and a significant reduction or absence of breath sounds. When a small amount of air accumulates in the pleural cavity, weakened breath sounds on the affected side may be the only suspicious sign.

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Written by Han Shun Li
Pulmonology
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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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Written by Li Jie
Orthopedics
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How to treat rib fracture and pneumothorax?

After a rib fracture, if a pneumothorax occurs, it is a very serious complication. There are three types of pneumothorax: closed pneumothorax, open pneumothorax, and tension pneumothorax. The simplest is the closed pneumothorax. If the area of lung compression in a closed pneumothorax is less than 30%, there is a hope for self-healing, and generally no special treatment is needed; if the lung compression exceeds 30%, it might be necessary to place a closed thoracic drainage tube to drain the air accumulating in the chest cavity, which may need to stay in the chest cavity for about a week. This is the treatment for a closed pneumothorax. If it is an open pneumothorax, it means there is an open wound on the chest. The treatment principle is to convert the open pneumothorax to a closed pneumothorax, which means sealing the wound, turning it into a closed pneumothorax, and then taking x-rays to assess the degree of lung compression. If the compression is significant, closed thoracic drainage is still necessary; if the compression is less severe, observation can continue. For a tension pneumothorax, it is the most severe type of pneumothorax and must be taken very seriously. Emergency placement of a closed thoracic drainage is recommended and must be handled promptly, as it could pose a life-threatening risk. In summary, once a pneumothorax occurs following rib fractures, it must be taken seriously. It is necessary to go to the hospital's thoracic surgery or orthopedic department for formal and timely treatment to prevent potentially severe consequences.