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Pneumothorax


• First aid for respiratory distress


An air leak, or collapsed lung, is a fairly rare occurrence in children. A pneumothorax develops when air leaks from the lung and enters the pleural cavity, which is the area of the chest adjacent to the lungs. Once trapped, the air cannot escape, and the pressure it creates can collapse the adjacent lung and cause serious breathing difficulties. The severity of a pneumothorax depends upon the extent of the lung collapse and the degree of preexisting lung disease. Newborns are most commonly (and dangerously) affected by this condition, but it also occurs in older children and adults. Emergency care is essential in afflicted babies; however, most recover completely.

WHAT CAUSES PNEUMOTHORAX?
The exact cause of pneumothorax is not always clear. Most commonly pneumothorax results from increased pressure within the lung secondary to air trapping. Older children (especially males) may develop a spontaneous pneumothorax, which is simply a pneumothorax with unknown cause. The tendency to develop this kind of pneumothorax seems to run in families.

Pneumothorax may be caused by physical trauma, such as a penetrating injury to the chest. An inhaled foreign object also can trigger pneumothorax. It also may develop as a complication of a respiratory disease such as pneumonia, cystic fibrosis or a lung abscess.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS PNEUMOTHORAX?
The main clue is the sudden development of rapid, shallow breathing. The child may be in pain, and breathing sometimes becomes difficult. Restlessness and irritability are also common. These signs are particularly important if the child already has a respiratory disease.

IS MEDICAL ATTENTION NECESSARY?
Definitely. A child with pneumothorax risks oxygen deprivation because of loss of lung function.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS PNEUMOTHORAX?
If a newborn shows signs of pneumothorax, the hospital staff may confirm the diagnosis by shining a bright light on the child's chest; the chest area into which air has leaked may become highly translucent. Chest X rays provide definitive diagnosis.

WHAT TREATMENTS ARE AVAILABLE?
Treatment varies with the extent of the pneumothorax and the severity of the underlying disease. A small pneumothorax (affecting less than five percent of the lung) in an otherwise healthy child can resolve on its own within a week. Spontaneous pneumothorax usually only requires observation.

However, recurrent pneumothorax or any lung collapse affecting more than five percent of the lung may require surgical intervention to release the trapped air. This usually involves inserting a tube into the pleural area to allow trapped air to escape.

PREVENTING PNEUMOTHORAX
There is no known prevention for pneumothorax. In the case of infants, the best protection is competent emergency treatment if any respiratory problem arises. In older children, especially those who have had respiratory diseases, be alert to the signs and symptoms of this complication and get prompt medical care if they develop.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.

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