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(Pediatrics in Review. 2008;29:69-70.)
© 2008 American Academy of Pediatrics

In Brief

Pneumothorax

The first 20% of the full text of this article appears below.

Spontaneous Pneumothorax. Sahn S, Heffner J. N Engl J Med. 2000;342 :868 –874[Free Full Text] Pneumothorax. Baumann M, Noppen M. Respirology. 2004;9 :157 –164[CrossRef][Medline] The Intracacies of Pneumothorax: Management Depends on Accurate Classification. Dincer H, Lipchik R. Postgrad Med. 2005:118 . Available online at: http://www.postgradmed.com/issues/2005/12_05/dincer.htm Trauma and The Paediatric Lung. Ruddy R. Paediatr Respir Rev. 2005;6 :61 –67[CrossRef][Medline]

Pneumothorax, one type of lung disorder in the air leak syndrome spectrum, is defined as the presence of air between the visceral and parietal pleura that leads to lung collapse. Air leaks through holes in the lung tissue into the spaces outside the lung airways. Normally, the pressure in the pleural space is lower than that inside the lungs. If air enters the pleural space, the pressure becomes greater than that in the lung, which then collapses partially or completely. A tension pneumothorax is caused when air enters the pleural space during inspiration but cannot exit during exhalation. The positive pressure results in collapse of the involved lung and a shift of the mediastinal structures to the contralateral side, leading to a decrease in cardiac output as a consequence of decreased venous return.

Pneumothorax usually is classified as either traumatic or spontaneous. Trauma-related pneumothorax can be iatrogenic or accidental, and spontaneous pneumothorax can be primary (without clinically or radiographically apparent lung or chest wall disease) or secondary (a complication of chronic or acute lung disease).

Transthoracic needle aspiration or biopsy is the leading cause of iatrogenic pneumothorax. Other common causes include thoracentesis and central line placement. Mechanical ventilation and cardiopulmonary resuscitation also may cause pneumothorax. In a newborn who has underlying lung disease, such as interstitial . . . [Full Text of this Article]


Kari Posner, MD
Joshua P. Needleman, MD
 Children's Hospital at Montefiore
Bronx, NY





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