Therapy varies with the extent of the collapse and the nature and severity of the underlying disease.
A tension pneu mothorax may emergently require drainage by needle thoracostomy. A small or even moderate-sized pneumothorax in an otherwise normal child may resolve without specific treatment, usually within about 1 wk. A small (<5%) pneumothorax complicating asthma may also resolve spontaneously.
Administering 100% oxygen may hasten resolution. Patients with chronic hypoxemia should be monitored closely during the administration of supplemental oxygen. Pleural pain deserves analgesic treatment. If there is >5% collapse or if the pneumothorax is recurrent or under tension, chest tube drainage is necessary.
Pneumothoraces complicating CF frequently recur, and definitive treatment may be justified with the 1st episode, even with <5% collapse.
Closed thoracotomy (simple insertion of a chest tube) and drainage of the trapped air through a catheter, the external opening of which is kept in a dependent position under water, is adequate to re-expand the lung in most patients; pigtail catheters are frequently used.
When there have been previous pneumothoraces, it may be indicated to induce the formation of Continue reading »

