New Technique Reduces Pneumothorax Treatment Pain

Analyzing the partial pressure of oxygen (O2) and carbon dioxide (CO2) during pneumothorax treatment helps reduce the resulting pain, according to a new study.

Researchers at Tianjin Chest Hospital (China) conducted a study involving 49 patients, monitoring pneumothorax conditions in real time by analyzing thoracic cavity gas during treatment in order to provide instructions for updating treatment strategy. To do so, they monitored partial pressures of O2 and CO2 in the thoracic cavity before and during treatment, and after chest tube clogging. Pneumothorax type was then diagnosed according to the partial pressure results, and the treatment strategy was updated accordingly.

Accordingly, the patients were divided into four groups; group A, consisting of 30 patients with a closed pneumothorax; group B, consisting of 10 patients with open pneumothorax; Group C, with 3 patients with tension pneumothorax; and Group D, consisting of 6 patients with closed pneumothorax who were re-diagnosed to have open pneumothorax upon second analysis. The cure rates of the four groups after treatment were as follows: Group A (97%), Group B (100%), Group C (100%) and Group D (100%). The study was published on August 6, 2015, in Technology.

“It is very important to design the optimal treatment strategy according to the actual severity status of the pneumothorax. However, the actual status in the chest cavity may not keep unchanged during the management of the pneumothorax,” said lead author Prof. Yuechuan Li, MD, chief physician in Tianjin Chest Hospital. “The most frequent complication associated with chest tubes is chest tube clogging. We have found that after remove the clogged chest tube, in many cases, we could use a less painful needle aspiration because the pneumothorax has changed to a closed pneumothorax.”

“By analyzing the thoracic cavity gas in real time, the partial pressure of carbon dioxide and oxygen, during the pneumothorax treatment, the therapeutic strategy is updated accordingly,” added study coauthor Said Hui Ma, MD. “In many cases, the following-up treatment can be updated to less painful management method, such as conservative management, or updated to needle aspiration instead of continue using chest tube drainage.”

Primary spontaneous pneumothorax is an abnormal accumulation of air in the pleural space that can result in the partial or complete collapse of a lung. It is likely due to the formation of small sacs of air (blebs) in lung tissue that rupture, causing air to leak into the pleural space, creating pressure that is manifest as chest pain on the side of the collapsed lung and shortness of breath. Often, people who experience a primary spontaneous pneumothorax have no prior sign of illness; the blebs themselves typically do not cause any symptoms and are visible only on medical imaging.

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Tianjin Chest Hospital