Collapsed Lung: Non-Injury-Related

What is a non-injury-related collapsed lung?

Collapsed lung is a term used to refer to pneumothorax, a potentially life-threatening condition. A pneumothorax happens when air enters the space between the rib cage and one of your lungs. The air causes part or all of the lung to collapse. It is then hard to breathe normally and your body gets less oxygen.

When a lung collapses without an injury, it is called a spontaneous pneumothorax.

How does it occur?

A pneumothorax can suddenly occur for no clear reason in otherwise healthy young people, with or without strenuous activity.

Middle-aged and older adults whose lungs have been damaged by asthma, chronic bronchitis, or emphysema may also have a spontaneous pneumothorax. It can happen when air leaks from a damaged lung or when, especially with forceful coughing, an air sac bursts and air flows between the lung and the chest wall. The chest fills with air, which presses on the lung, collapsing part or all of it. If the air has no way to escape, the buildup of trapped air increases pressure on the lung and can lead to a life-threatening problem called tension pneumothorax. A tension pneumothorax is life threatening because the air in the chest not only pushes on the lung, but it also pushes on the heart and keeps the heart from pumping normally.

What are the symptoms?

The symptoms are:

• chest pain
• trouble breathing, feeling short of breath
• sometimes lightheadedness.

If you have a tension pneumothorax, it is hard to breathe.

How is it diagnosed?

If your healthcare provider thinks you have a collapsed lung, diagnosis and treatment are usually done in an emergency room or hospital.

Your healthcare provider will ask about your symptoms and examine you. You will have a chest X-ray. You may have a blood test to measure the amount of oxygen and carbon dioxide in your blood. This is called an arterial blood gas test, or ABG.

How is it treated?

Treatment depends on the cause, size, and duration of the pneumothorax. A small pneumothorax causing mild or no symptoms may heal by itself. The extra air in the chest will be absorbed through the surrounding tissues over the next few days.

If you have a pneumothorax that is causing more than mild symptoms, you need treatment right away to remove the air from the chest so the lung can fill with air again.

• If the pneumothorax is small, the air may be removed with just a needle and syringe. You will feel immediate relief, but it may take several days for the lung to reexpand completely.
• If you have a larger pneumothorax, you will be given an anesthetic and then the air will be removed through a suction tube inserted between the ribs and through the wall of your chest. This allows the lung to reinflate. The chest tube has a seal that will keep the area airtight. The extra air gets sucked out of the chest, but no air can go back into the chest through the chest tube.
• If you have a tension pneumothorax, quick treatment is needed to relieve the pressure on the heart and lungs. Your healthcare provider may first use a needle and syringe to quickly remove air and reduce pain and discomfort. The lung will be able to reinflate. After this emergency treatment, a chest tube is usually placed to make sure the lung stays inflated and that the lung doesn’t collapse again.

While you are being observed in the emergency room, your healthcare provider will keep checking your breathing, heart rate, and blood pressure. You will be given oxygen if you need it.

If you had a small pneumothorax with mild or no symptoms and requiring no treatment, usually you will be allowed to go home the same day. You will be asked to return one or more times for chest X-rays to make sure the pneumothorax is getting smaller and the air is being absorbed.

You may need to stay at the hospital for at least a day or two if air was removed from your chest with a needle and syringe or with a chest tube. You will need to be observed to make sure your lung is reexpanding and is no longer at risk of collapsing again. Depending on other medical conditions you have, you may need to stay at the hospital longer.

How long will the effects last?

A small pneumothorax in a healthy adult may heal in a few days without treatment. Otherwise, recovery from a collapsed lung generally takes 1 or 2 weeks. You may have regular visits with your healthcare provider during this time.

How can I take care of myself?

• Follow the treatment your healthcare provider prescribes.
• If helpful for breathing and relieving chest pain, prop pillows behind your head and chest and take pain-relieving medicines such as acetaminophen or ibuprofen. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
• Rest.
• Avoid talking loudly and laughing.
• Take a cough suppressant to avoid coughing, if your healthcare provider recommends it.
• Avoid smoking.
• Ask your healthcare provider if you should be doing breathing exercises and, if so, how you should be doing them.
• Call your healthcare provider if:
  • You have symptoms of collapsed lung again.
  • You have a fever higher than 101.5° F (38.6° C).
  • You have chest pain or shortness of breath that gets worse.

How can I prevent a non-injury-related collapsed lung?

You may be able to keep from having another collapsed lung by getting the necessary medical treatment for any respiratory problem, such as asthma or emphysema, as soon as you start having symptoms. Also, do not smoke.

If both lungs of your lungs collapsed, or the same lung has collapsed more than once, you may need surgery to keep it from happening again.