Chopra Amit, Doelken Peter, Hu Kurt, Huggins John T, Judson Marc A
Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY.
Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY.
Chest. 2023 Sep;164(3):796-805. doi: 10.1016/j.chest.2023.04.049. Epub 2023 May 13.
Pressure-dependent pneumothorax is a common clinical event, often occurring after pleural drainage in patients with visceral pleural restriction, partial lung resection, or lobar atelectasis from bronchoscopic lung volume reduction or an endobronchial obstruction. This type of pneumothorax and air leak is clinically inconsequential. Failure to appreciate the benign nature of such air leaks may result in unnecessary pleural procedures or prolonged hospital stay. This review suggests that identification of pressure-dependent pneumothorax is clinically important because the air leak that results is not related to a lung injury that requires repair but rather to a physiological consequence of a pressure gradient. A pressure-dependent pneumothorax occurs during pleural drainage in patients with lung-thoracic cavity shape/size mismatch. It is caused by an air leak related to a pressure gradient between the subpleural lung parenchyma and the pleural space. Pressure-dependent pneumothorax and air leak do not need any further pleural interventions.
压力依赖性气胸是一种常见的临床情况，常发生于存在脏层胸膜受限、部分肺切除或因支气管镜下肺减容术或支气管内阻塞导致肺叶肺不张的患者进行胸腔引流后。这种类型的气胸和空气泄漏在临床上并不严重。未能认识到此类空气泄漏的良性本质可能导致不必要的胸膜操作或延长住院时间。本综述表明，识别压力依赖性气胸在临床上很重要，因为由此产生的空气泄漏并非与需要修复的肺损伤相关，而是与压力梯度的生理后果有关。压力依赖性气胸发生于肺-胸腔形状/大小不匹配的患者进行胸腔引流期间。它由与胸膜下肺实质和胸膜腔之间的压力梯度相关的空气泄漏引起。压力依赖性气胸和空气泄漏无需任何进一步的胸膜干预。
