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For newborn infants with pneumothorax, different management strategies have been suggested including careful observation, thoracentesis (needle aspiration), or insertion of a chest tube. [27] Needle aspiration may reduce the need for a chest tube, however, the effectiveness and safety of both invasive procedures have not been fully studied.
Depending on etiology, a pneumothorax is classified as spontaneous, traumatic and iatrogenic. A spontaneous pneumothorax is further classified as primary and secondary, with the former occurring in individuals with no clinical lung disease and the latter occurring as a complication of preexisting lung disease.
Image shows early occurrence of tracheal deviation. Tracheal deviation is a clinical sign that results from unequal intrathoracic pressure within the chest cavity.It is most commonly associated with traumatic pneumothorax, but can be caused by a number of both acute and chronic health issues, such as pneumonectomy, atelectasis, pleural effusion, fibrothorax (pleural fibrosis), or some cancers ...
Chest tubes can also be placed using a trocar, which is a pointed metallic bar used to guide the tube through the chest wall. This method is less popular due to an increased risk of iatrogenic lung injury.
Iatrogenic hemothorax resulting from the Nuss procedure. A showing no hemothorax, b showing hemothorax, and c showing resolution after treatment. Air in the chest (pneumothorax) is one of the more frequent complications. A chest tube may be required or aggressive breathing exercises and close monitoring may be adequate. [citation needed]
Iatrogenic hemothorax can occur as a complication of heart and lung surgery, for example the rupture of lung arteries caused by the placement of catheters, thoracotomy, thoracostomy, or thoracentesis. The most common iatrogenic causes include subclavian venous catheterizations and chest tube placements, with an occurrence rate of around 1%. [5]
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A technique called pleurodesis can be used to intentionally create scar tissue within the pleural space, usually as a treatment for repeated episodes of a punctured lung, known as a pneumothorax, or for pleural effusions caused by cancer. While this procedure usually generates only limited scar tissue, in rare cases a fibrothorax can develop. [6]