Secondary spontaneous pneumothorax(SSP): Symptoms, Diagnosis & Treatments
Secondary spontaneous pneumothorax (SSP) is a pneumothorax that appears as a complication of previously existing lung disease. Although almost all types of pulmonary complications can be seen, chronic obstructive pulmonary disease is the most common cause of SSP and 50 to 70% of SSP is caused by COPD. The severity of COPD is associated with the risk of SSP. For example, over 30% SSP due to COPD patients have FEV1 less than 1 liter and FEV1 / FVC ratio less than 40%. This OSN patient was also a COPD patient and showed SSP due to complication.
Symptoms of patients with secondary spontaneous pneumothorax are manifested by air volume, tension, and age and respiratory reserve in the pleural space. Most SSP patients complain of dyspnea and chest pain on the chest with pneumothorax. Symptoms are more severe than in patients with primary spontaneous pneumothorax, because patients with SSP usually have less pulmonary reserve due to underlying lung disease. Patients with SSP due to infectious causes may have cough, fever, chills, or fatigue.
Patients with a relatively large pneumothorax have decreased thoracic expansion and decreased respiratory sounds, and the name of overtraining is present. Tension pneumothorax may be suspected if there is a high breathing or hemodynamic compromise (hypotension / tachycardia) and urgent reduction is needed. In pneumothorax, tracheal deviation is a rare and late finding.
Chest radiographs can be used to confirm the presence of pneumothorax, and chest computed tomography is recommended if it is uncertain by X-ray. Chest radiographs can measure the size of the pneumothorax as well as the presence or absence. The size of the pneumothorax is measured through the interpleural distance, which is the length between the visceral pleura and the parietal pleura at the hilum height. A 2 centimeter interpleural distance is considered to be 50% pneumothorax and a relatively large pneumothorax.
Treatment of hypoxemia in almost all secondary spontaneous pneumothorax patients and supplemental oxygen therapy to promote air absorption from the pleural space. Patients with SSP have pleural drainage in most patients because of the high probability of persistent air leakage and pneumothorax expansion due to underlying lung disease. Patients with dyspnea or large pneumothorax are promptly inserted because chest tube insertion is indications and has potential for progressive respiratory impairment or tension pneumothorax.
For patients with persistent pneumothorax despite chest tube insertion, video assisted thoracoscopy or pleurodesis is recommended rather than just chest tube.
Symptoms of patients with secondary spontaneous pneumothorax are manifested by air volume, tension, and age and respiratory reserve in the pleural space. Most SSP patients complain of dyspnea and chest pain on the chest with pneumothorax. Symptoms are more severe than in patients with primary spontaneous pneumothorax, because patients with SSP usually have less pulmonary reserve due to underlying lung disease. Patients with SSP due to infectious causes may have cough, fever, chills, or fatigue.
Patients with a relatively large pneumothorax have decreased thoracic expansion and decreased respiratory sounds, and the name of overtraining is present. Tension pneumothorax may be suspected if there is a high breathing or hemodynamic compromise (hypotension / tachycardia) and urgent reduction is needed. In pneumothorax, tracheal deviation is a rare and late finding.
Chest radiographs can be used to confirm the presence of pneumothorax, and chest computed tomography is recommended if it is uncertain by X-ray. Chest radiographs can measure the size of the pneumothorax as well as the presence or absence. The size of the pneumothorax is measured through the interpleural distance, which is the length between the visceral pleura and the parietal pleura at the hilum height. A 2 centimeter interpleural distance is considered to be 50% pneumothorax and a relatively large pneumothorax.
Treatment of hypoxemia in almost all secondary spontaneous pneumothorax patients and supplemental oxygen therapy to promote air absorption from the pleural space. Patients with SSP have pleural drainage in most patients because of the high probability of persistent air leakage and pneumothorax expansion due to underlying lung disease. Patients with dyspnea or large pneumothorax are promptly inserted because chest tube insertion is indications and has potential for progressive respiratory impairment or tension pneumothorax.
For patients with persistent pneumothorax despite chest tube insertion, video assisted thoracoscopy or pleurodesis is recommended rather than just chest tube.
