Pneumothorax essentials: insights into causes and care

Background- Pneumothorax is classified as spontaneous or traumatic, with primary and secondary subdivisions. Diagnosis relies on patient history and radiological investigations. Management often requires interventions such as intercostal chest tube placement and Oxygen support. Objectives- To study the clinical profile, etiology, treatment given and outcome of patients presenting with pneumothorax or developed pneumothorax during the course of treatment in Intensive Respiratory Care Unit in Tertiary Care Hospital. Methods- Medical records of patients diagnosed with pneumothorax was analysed to identify clinical profile and outcome of patients. Result- In the study involving 112 patients (86-males and 26 females), 10.7% had Primary Spontaneous Pneumothorax, 47.3% COPD (32% of COPD were sequalae to tuberculosis), 16.9% active tuberculosis, 8.9% ILD, and 16.9% iatrogenic pneumothoraces (mostly from positive pressure ventilation). 7 patients received high-flow oxygen, majority required ICD tube insertion, out of which 41 also needed oxygen, 17 ventilatory support (82% of these succumbed to underlying illness). 15 Tuberculosis patients were discharged with ICDs for OPD follow-up; later, their ICDs were removed. 34.8% patients underwent pleurodesis: 15 with Oxytetracycline, 15 with Steritalc slurry, 8 with betadine, and 1 with Doxycycline. Among them, 6 experienced recurrences: 3 with betadine and 3 with Oxytetracycline. Conclusion- In conclusion, our study highlights Tuberculosis and COPD as significant causes of pneumothorax in a developing country with Post Tb Sequalae also being an important contributor. Alongside interventions like pleurodesis, prompt recognition and tailored treatments are crucial for improving patient outcomes.