Pneumothorax Treatment

How is Pneumothorax Diagnosed?

The diagnosis of pneumothorax relies on the patient's medical history, physical examination, and appropriate tests. Chest X-ray is usually the initial imaging test of choice, with a possible role of ultrasound as a quick bedside test in critically ill patients. The diagnosis can also be confirmed with a CT scan in cases of uncertainty or when small pneumothoraces do not show up on chest X-ray. In moderate-to-severe cases, ABGs can be performed to assess the levels of oxygen and carbon dioxide.

Note: If you suspect tension pneumothorax in an unstable patient, treat it as a clinical

emergency and do not delay treatment to obtain imaging.

How is Pneumothorax Treated Based on Severity?

Treatment of pneumothorax is guided by its severity, the extent of lung collapse, and the patient's clinical condition. The appropriate treatment options for different severity levels are included in the table below:

Types of Pneumothorax Treatment and Their Treatment

Pneumothorax can be classified into different types based on its cause, underlying condition, and clinical presentation, with each type requiring a different treatment approach. The table below outlines the different types and their respective treatments.

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Medications for Pneumothorax Treatment

Medications used during pneumothorax treatment mainly focus on pain control and supporting procedures such as thoracostomy or needle aspiration. These may include:

• Local Anesthetics: Administered at the thoracostomy site to reduce pain during the procedure.

• Intravenous or Oral Pain Medications: Used to manage pain caused by pneumothorax or treatment procedures.

• Prophylactic Antibiotics: May be considered during chest tube insertion to reduce the risk of insertion-site infection and complications such as empyema.

Note: Medicines used during pneumothorax treatment should be taken only as prescribed by a doctor.

Other Treatments for Pneumothorax Treatment

Other treatments for pneumothorax focus on removing air from the lung, allowing the lung to re-expand and preventing recurrence. Depending on the patient's condition, other treatments may include:

• Needle Aspiration: A needle is inserted into the lung to remove trapped air and help the lung re-expand.

• Chest Tube Drainage: A chest tube or small-bore pigtail catheter may be inserted to continuously remove air from the lung.

• Thoracostomy: Emergency thoracostomy or chest tube placement is required for traumatic or tension pneumothorax.

• Oxygen Therapy: Oxygen may be used with observation and serial chest X-rays in selected patients, although supporting evidence is limited.

• Pleurodesis: This procedure helps prevent a pneumothorax from recurring by causing the lung to adhere to the chest wall. It may be recommended for people who have a high risk of recurrent primary spontaneous pneumothorax.

• Apical Pleurectomy: Surgical removal of part of the pleura may be considered to reduce the risk of recurrent pneumothorax.

• Video-Assisted Thoracoscopic Surgery (VATS): VATS may be considered for large, recurrent pneumothorax.

• Regional anaesthesia: Techniques such as intercostal nerve blocks may be used for pain management, including after surgery.

Note: A healthcare professional should determine the most appropriate treatment based on the individual clinical situation.

Ayurvedic and Alternative Treatments for Pneumothorax Treatment

Ayurvedic medicines are prepared using natural herbs that boost the immune system of your body and help you with the symptoms related to pneumothorax. The commonly used herbs are mentioned below:

• Vasa (Malabar Nut): Reduces swelling and soothes any constrictions in the airways.

• Yashtimadhu (Liquorice Root): Coats the lungs to help protect and heal them.

• Tulsi (Holy Basil): Clears the lungs of mucus to help improve oxygen saturation.

• Pippali (Long Pepper): Beneficial in mucus reduction and for aiding the function of the lungs.

• Pushkarmool (Indian Elecampane): May help improve lung strength and relieve discomfort.

• Sitopaladi Churna: This classical Ayurvedic formulation combines several herbs that may support the respiratory system, ease breathing, and enhance lung capacity.

• Shwas Kuthar Rasa: Helps reduce inflammation and clear the respiratory passages.

Note: Ayurvedic approaches may be used as supportive care alongside appropriate medical treatment for pneumothorax. Consult your doctor before including them in your treatment plan.

Home Care Tips to Manage Pneumothorax Treatment

Following proper home-care measures after pneumothorax treatment can support recovery and help prevent complications. These include:

• Follow the doctor's instructions for changing the bandage.

• Keep the chest-tube insertion area clean and dry.

• Empty the drainage container before it becomes full.

• Learn how to empty the drainage container correctly.

• Change the gauze covering daily or whenever it becomes wet.

• Avoid bathing or swimming while the chest tube is in place.

• Keep the area dry while showering.

• Maintain a record of the drainage, including its date, time, amount, and color.

• Attend all follow-up appointments.

Latest Treatment of Pneumothorax in India

Recent advances in pneumothorax care are directed at minimally invasive and tailored treatments that take into account the presentation, the patient's condition, and likelihood of repeat episodes. These treatments include observation, in appropriate patients, ambulatory chest tube, and needle pleuracentesis.

Chemical pleurodesis, VATS, bullectomy, or thoracotomy may be alternatives in patients with a persistent air leak or repeat pneumothorax. In some patients with a persistent air leak, newer treatments, such as autologous blood pleurodesis and endobronchial therapies, can be utilized.

How Long Does Pneumothorax Treatment Take?

The time required for pneumothorax treatment depends on the size of the pneumothorax, treatment approach, and how quickly the lung re-expands. The typical duration for different treatment options is given below.

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Note: The duration may vary from person to person depending on the severity of the pneumothorax, presence of an air leak, response to treatment, and need for additional procedures.

Pneumothorax Treatment Side Effects

Side effects of treatment of pneumothorax depend on the type of treatment used. Some side effects and complications can occur at the time of or after surgery or a chest-tube insertion, including:

• Re-expansion pulmonary edema

• Chest-tube malposition

• Bleeding

• Injury to internal organs

• Cardiac injury

• Infection

• Persistent air leak

• Failure of the lung to re-expand

Lifestyle Changes for Managing Pneumothorax Treatment

Making certain lifestyle changes after pneumothorax treatment may help reduce the risk of another pneumothorax. These include:

• Avoid smoking and tobacco products.

• Avoid drug use, especially inhaled drugs.

• Avoid scuba diving or deep-sea diving.

• Avoid activities involving drastic changes in air pressure.

• Avoid air travel until your doctor confirms that it is safe.

Triggers That Can Worsen Symptoms of Pneumothorax Treatment

Certain factors may increase the risk of worsening symptoms or recurrence in people with pneumothorax. Such factors include:

• Smoking

• Vaping and inhalation of tobacco or other substances

• Large fluctuation in ambient air pressure

• Heavy exertion or trauma while healing

• Poorly controlled pre-existing lung condition

• Positive-pressure ventilation of an open pneumothorax

Pneumothorax Treatment Cost

The cost of treating pneumothorax in India depends on factors such as the type and size of the condition, the mode of treatment, the hospital where you are treated, your duration of hospital stay, and the presence or absence of complications. Typically, treatment can cost anywhere between ₹50,000 and ₹4 lakh, or more. Managing a simple pneumothorax with observation or chest tube drainage costs between ₹50,000 and ₹1.5 lakh. The cost of managing traumatic pneumothorax with chest tube insertion can be anywhere between ₹1 lakh and ₹3 lakh.

Treating tension pneumothorax with emergency management and ICU can cost ₹1.5 lakh to ₹4 lakh. VATS for persistent pneumothorax can cost ₹2 lakh to ₹4.5 lakh. Treating a recurrent pneumothorax with more than one surgical procedure costs from ₹2.5 lakh to ₹5 lakh or more.

Does Health Insurance Cover Pneumothorax Treatment in India?

Yes, health insurance in India covers treatment of pneumothorax which needs hospitalization, depending on your policy terms and conditions. Usually, room charges, ICU, nursing care, and medical management would be covered. Surgeries such as VATS and open thoracotomy might be covered.

Also, OPD-related expenses such as tests like CT scans, blood tests, chest X-ray, and medications are only covered if OPD cover is part of the plan. Needle aspiration is covered as a day care procedure by certain policies.

A health insurance cover of ₹10 lakh-₹15 lakh can help offset the possible expenses involved in treating pneumothorax, subject to severity, treatment, and individual health requirements.

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