Pneumothorax and physiotherapy

Pneumothorax is the existence and storage of external air or pulmonary air in the pleural cavity. (We explain this in this video),

Pleura, what is it?

The pleura is a bilayer membrane that covers the lungs and connects them to the rib cage. (Fig. 1).

It consists of two layers: the external layer which adheres to the rib cage is called the costal or parietal pleura (Fig.1. Orange and fig.2), and the internal layer or pulmonary or visceral pleura (Fig.1. Red and fig.2) which borders the lungs.

When it is injured, air usually enters the interior of the pleura in the interpleural space, a virtual space (Fig.1. Blue and fig.2) that serves as a coupling and which only stops adhering to each other when there is a cause of injury, infection, etc. This causes the lungs to lose volume and collapse (Fig.3. Black zone), thus the person feels an extreme sensation of lack of air.

Fig.1. Rib Pleura (orange), Lung Pleura (red) and Interpleural Space (blue)

Fig.2.

Fig.3.

Causes of Pneumothorax

By injury or traumatic mechanism:

• Injury (by stabbing, traffic accidents…)
• Exposure to high pressure (diving).

By pathological process:

• COPD (chronic bronchitis, emphysema).
• Neoplasms (Cancer).
• Cystic Fibrosis.
• Tuberculosis, etc.

Symptoms of pneumothorax

• Chest pain.
• Breathing difficulty.
• Nasal flaring.
• Cyanosis.
• Tachycardia.
• Chest pressure.
• Fatigue.
• Medical treatment

If the pneumothorax is mild, it usually recedes spontaneously. If it is serious, medical treatment is oriented towards pleural drainage and oxygen therapy.

Physiotherapeutic treatment

It is advisable to start treatment while the patient is on preural drainage and is oriented towards forced exhalation exercises, stabilisation of respiratory mechanics, strengthening of respiratory and general muscles and improvement of ventilation in both lungs.

When the patient has the pleural drainage removed, it is advisable to continue with physiotherapy for a period of time to improve the lung capacity.

Physiotherapy plays a fundamental role in the treatment of pneumothorax .