Tension pneumothorax is a medical emergency that occurs when air accumulates in the pleural space, the area between the lung and the chest wall, and cannot escape. This leads to an increase in pressure within the pleural space, compressing the lung and affecting the heart and major blood vessels, which can severely compromise a person's ability to breathe and circulate blood properly. Tension pneumothorax is considered life-threatening and requires immediate medical attention.

Here's how tension pneumothorax typically develops and its key characteristics:

1. **Mechanism of Development**: Tension pneumothorax usually arises from a simple pneumothorax, which is the presence of air in the pleural space. This can occur due to various reasons, such as trauma (e.g., a rib fracture puncturing the lung), lung diseases, medical procedures, or spontaneously. In a tension pneumothorax, the one-way valve mechanism is created when air enters the pleural space during inspiration but cannot exit during expiration, causing pressure to build up.

2. **Symptoms**: The symptoms of tension pneumothorax can develop rapidly and can include severe difficulty breathing (dyspnea), rapid heart rate (tachycardia), chest pain or discomfort, cyanosis (bluish discoloration of the skin), anxiety, and a sense of impending doom. As the condition progresses, a person's mental status may deteriorate due to reduced oxygen supply to the brain.

3. **Physical Examination Findings**: On physical examination, a person with tension pneumothorax may exhibit decreased or absent breath sounds on the affected side of the chest, hyperresonance (abnormal resonance to percussion) over the affected area, and tracheal deviation away from the affected side due to the pressure pushing the structures in the chest.

4. **Treatment**: Tension pneumothorax is a medical emergency and requires immediate intervention. The primary treatment is to release the accumulated air and relieve the pressure. This is often done by inserting a large-bore needle or catheter into the pleural space, a procedure known as needle decompression or thoracostomy. This allows the trapped air to escape, restoring normal lung expansion and relieving pressure on the heart and major vessels.

5. **Follow-up Care**: After initial stabilization with needle decompression, further treatment involves placing a chest tube, a flexible tube inserted through a small incision in the chest, to drain the remaining air and fluid from the pleural space. This helps prevent the recurrence of tension pneumothorax and allows the lung to fully re-expand.

Tension pneumothorax is a critical condition that requires rapid recognition and intervention. If you suspect someone might be experiencing tension pneumothorax, it's important to seek medical assistance immediately. Early diagnosis and prompt treatment are crucial to ensuring the best possible outcome for the affected individual.

свернуть