What is an injury-related collapsed lung?

Collapsed lung is a term used to refer to pneumothorax, a potentially life-threatening condition. A pneumothorax occurs when air enters the space between the two layers of the pleura. (The pleura is the membrane that surrounds each of your two lungs.) The air separates the two layers, and causes part or all of one of the lungs to collapse and lose the air that is normally inside the lung. It is then hard to breathe normally and your body gets less oxygen.

How does it occur?

Injury to the chest is one cause of collapsed lung. Most chest injuries that cause collapsed lung occur in car accidents. A third of these injuries cause death from lung damage.

Collapsed lung can be caused by a penetrating injury, such as a stab or bullet wound. It also can be caused by nonpenetrating injuries, such as fractured ribs, electric shock, or near drowning.

Tension pneumothorax is a more serious condition in which the pleural cavity fills with air and continues to enlarge. This condition is life-threatening because the air in the pleural cavity puts more pressure on the heart.

What are the symptoms?

Symptoms include pain and difficulty breathing. In cases of tension pneumothorax, your neck veins are enlarged. In addition, the breathing movements on the affected side of the chest may look different.

How is it diagnosed?

If the doctor suspects pneumothorax or if you have been injured in the chest, diagnosis and treatment are usually done in a hospital.

The doctor will order a chest x-ray and an electrocardiogram (ECG). An ECG is a painless procedure for recording the electrical impulses that pass through the heart to control its activity. The doctor will also take a blood sample from one of your arteries to measure the amount of oxygen and carbon dioxide in your blood. This is called an arterial blood gas test.

How is it treated?

Treatment depends on the cause, size, and duration of the pneumothorax. The injury may heal by itself, but hospitalization and treatment may be necessary to get rid of the excess air.

Immediate treatment is to remove the air so the lung can reexpand to its original capacity. The air is removed through a suction tube inserted through the wall of the chest or, if the pneumothorax is small, through a needle and syringe. Reexpansion usually occurs in 48 to 72 hours.

The doctor will measure your breathing by monitoring the up and down movements of your chest. Your heart rate and blood pressure will be checked frequently and you will be given oxygen as necessary.

If an open chest wound is involved, the doctor will close it by covering it with a dressing and airtight seal.

If necessary, a chest tube will be inserted into the pleural cavity to reinflate the lung and keep the area airtight while the underlying cause is treated.

For tension pneumothorax the doctor may use a procedure called needle thoracentesis to reduce pain and discomfort. A needle is inserted into the pleural cavity to remove the air.

How long will the effects last?

Recovery from collapsed lung generally takes 1 to 2 weeks. A small pneumothorax in a healthy adult may heal in a few days without treatment. More serious cases need treatment.

Because the effects vary depending on the cause and individual response to treatment, it is best to discuss progress and ongoing effects with your doctor.

How can I take care of myself?

Follow the full treatment the doctor prescribes. In addition:

• Try to be calm and practice deep breathing.

• Prop pillows behind your head and chest and take pain- relieving medications such as acetaminophen or ibuprofen to reduce pain.

• Rest.

• Eat nutritious foods.

• Avoid loud talking and laughing.

• Take a cough suppressant to avoid coughing, if necessary.

• Elevate the head of your bed.

• Avoid smoking.

Call the doctor if:

• Symptoms of collapsed lung recur.

• Your temperature rises to 101 degrees F (38.3 degrees C).

• Chest pain or shortness of breath increases.

• You have painful coughing.

How can I prevent an injury-related collapsed lung from recurring?

Many cases of collapsed lung occur in car accidents. To avoid chest injuries, wear seat belts when driving or riding in a car. Secure infants and young children in car seats.