Thoracic Air Leaks ✅ Flashcards
What are thoracic air leaks?
Collections of gas outside the pulmonary space
Give 4 types of thoracic air leaks
- Pneumothorax
- Pneumomediastinum
- Pneumoperitoneum
- Subcutaneous emphysema
What conditions increase the risk of pulmonary air leaks?
- Respiratory distress syndrome
- Meconium aspiration syndrome
- Congenital diaphragmatic hernia
- Previous pneumothorax
- Pulmonary hypoplasia
- Pulmonary interstitial emphysema
What is the most common cause of pulmonary air leaks?
RDS
What % of infants with RDS get pulmonary air leaks?
5-20%
What % of infants with meconium aspiration syndrome get pulmonary air leaks?
20-50%
What % of infants with a congenital diaphragmatic hernia get pulmonary air leaks?
14%
What % of infants with a previous pneumothorax get a contralateral pneumothorax?
14%
What is the first step in the development of an air leak syndrome
Damage of the respiratory epithelium allows air to enter the pulmonary space, causing pulmonary interstitial emphysema
What happens if there are continued high transpulmonary pressures with pulmonary interstitial emphysema?
Air dissects towards the visceral pleura and/or hilum by the peri-bronchial or perivascular space
When does a pneumothorax develop from pulmonary interstitial emphysema?
When the pleural surface is ruptured resulting in leakage of air into the pleural space
What can acute pneumothorax lead to?
- Collapse of underlying lung
- Mediastinal shift
- Cardiovascular compromise
How can acute pneumothorax lead to cardiovascular compromise?
Due to reduced venous return and cardiac output
How is a diagnosis of acute pneumthorax made?
Based on suspicion of deterioration of clinical condition or increased oxygen requirement, and clinical signs
What are the clinical signs of pneumothorax?
- Reduced air entry
- Mediastinal shift
