CHEST Select - Critical Care Self-Study Resources-Pneumothorax in the Critically Ill Patient

Pdf Summary

Pneumothorax is a common problem in critically ill patients, occurring in 4% to 15% of patients in the ICU. It is considered a medical emergency and requires prompt recognition and intervention. The diagnosis of pneumothorax can be made with physical examination findings or radiographic studies such as chest radiographs, ultrasonography, or CT scanning. Ultrasonography has emerged as the preferred diagnostic procedure for pneumothorax, if expertise is available. Treatment options for pneumothorax include observation, tube thoracostomy, or surgical intervention. The use of small-bore catheters as first-line therapy for pleural intervention is recommended in the majority of ventilated patients. If there is suspicion for tension pneumothorax, immediate needle decompression and tube thoracostomy should be performed. In patients with persistent air leak or failure of the lung to expand, early thoracic surgical consultation is recommended. Bronchoscopic interventions, such as the placement of valves, have been used successfully for the treatment of prolonged air leaks. However, further research is needed to determine the efficacy of these interventions in critically ill patients. Overall, prompt recognition and intervention are crucial in managing pneumothorax in critically ill patients.

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Curriculum Category Pulmonary Disease in Critical Care

Keywords

pneumothorax

critically ill patients

ICU

diagnosis

treatment options

tube thoracostomy

surgical intervention

ventilated patients

tension pneumothorax

prompt recognition