Pneumothorax - accumulation of air in the pleural cavity, which usually leads to compression of the lung, reduce the respiratory (ventilated) surface buy ventolin online. Depending on rasprosfanennosti following types of pneumothorax: a total, when the air fills the pleural cavity; partial or plaschevidny when the light is not completely fallen down, and the air envelops him from all sides, and otfanichenny pneumothorax.

By the nature of the damage and messages with the external environment is isolated indoor and outdoor pneumothorax, as well as valve and spontaneous pneumothorax.

Open pneumothorax occurs when penetrating wounds fudnoy cells. With this type of pneumothorax, pleural cavity freely communicates with ambient air through an open wound fudnoy cells (open outward) or a defect in the bronchus or fahee (opening inside). The pressure in the pleural cavity on the affected side becomes positive. Due to its elastic properties of the lung collapses. There is a so-called paradoxical breathing. When you inhale air enters the healthy lung is not only the atmosphere but also of collapsed lung on the side of the injury. As you exhale, some of the air out of the healthy lung enters the collapsed lung, several inflating it. Thus, when the open pneumothorax collapsed lung commits a weak respiratory movements, a few cracking down on exhalation and downs during inspiration, t. E. Performs during breathing movements, inverse healthy lungs. As a result, the depth of breathing decreases sharply, broken ventilation, lead to respiratory and cardiac failure, respiratory hypoxia, shock. Often there is a "flotation" mediastinal, t. E. Its displacement in the sick, the healthy side with each inhalation and exhalation. At untimely medical aid, death can occur from the shock, cardiac abnormalities.

Clinical presentation and diagnosis. The patient complains of shortness of breath, pain in the injured. On examination revealed a wound from a knife or gunshot wound, from which the noise when breathing distinguished air and blood splatter. When percussion on the affected side are determined by the high tympanic sound on auscultation - the weakening or disappearance of respiratory noise. When X-ray reveals the shadow kollabirovannogo easy with clear outer boundary, the absence of a pulmonary drawing on the periphery.

Treatment. First aid for an open outward pneumothorax (the wound of the chest wall) is reduced to the imposition of occlusive dressings, sealed the wound. Parallel to this, carry out activities to maintain the function of the cardiovascular and respiratory system, anesthesia, recovery of blood loss by introducing a variety of means.

The hospital produced debridement and suturing wounds of the chest wall, followed by a constant aspiration of air and accumulates in the pleural cavity through the drainage of fluid. At the same time damage the lung volume of operation is determined by the nature of the damage. The operation is carried out with maximum preservation of healthy body tissue. At the end of the operation wound and drain and produce a constant aspiration of the contents in the postoperative period.

With an open pneumothorax, communicating with the outside through the bronchial tubes, damaged destructive processes in the lung (breakthrough abscess, tuberculous cavity, abdominal cancers), treatment is aimed at eliminating the main process thoracostomy constant aspiration of fluid and air. With a large defect in the bronchus and an unsuccessful attempt to straighten easy resort to temporary obstruction of the bronchus with a plug of foam rubber or other material, after which the flow of air in the pleural cavity is terminated, created favorable conditions for the unfolding of the collapsed lung. Visceral pleura straightened light during the obturation of the bronchus may merge with the parietal, which will lead to the elimination of pneumothorax. To cure the main lung diseases using made both conservative and operative methods.

The most severe form of pneumothorax and difficult to diagnose and treat a pneumothorax valve. The valve is a kind of an open pneumothorax. It differs in that the air enters the pleural cavity through a narrow opening in the lung tissue (or chest wound) for each inhalation and exhalation when not fully extends outwardly from the overlap of the holes in the pleura surrounding tissue forming valve similarity. In this regard, the air inhaled with each breath enters the pleural cavity and is only partially exposed during exhalation. Gradually increasing the pressure in the pleural space compresses the lung and major blood vessels.

In some cases, the air through valve pneumothorax "valve" is pumped in only one direction, into the pleural cavity. The pressure (voltage) in the pleural cavity increases rapidly. This type of valve called a pneumothorax tense. When the pressure in the pleural cavity becomes very high, the light completely collapses, the mediastinum is shifted in the opposite direction, thus compressing the healthy lung. Sometimes there flotation mediastinum (t. E. Moving it while breathing in one direction and then the other). Therefore bend large vessels, greatly disturbed blood circulation and breathing, shock may develop.