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• W1979591389 abstract "SUMMARY AND CONCLUSIONS 1) Every initial pneumothorax is of necessity first a traumatic pneumothorax. The needle inserted into the (potential) pleural space punctures the visceral pleura and air escapes into the pleural space from the lung. This is true irrespective of the type or character of the needle used. 2) Initial manometer readings are those of this traumatically produced pneumothorax; it is into this space that we add air from the pneumothorax apparatus. 3) The trauma to the lung varies with the size of the needle used. Small needles produce small openings into the lung, less air escapes. 4) Several additional factors determine the final size of the pneumothorax. Most important are the existence of contralateral involvement and the status of the underlying lung. If the disease is extensive, the remaining functioning parenchyma shows compensatory emphysema. When such lung is injured, air leakage is persistent and is aggravated by the constant activity of this functioning part of the lung. Severe and even dangerous dyspnoea may result. 5) Of the two principal factors determining the extent of the traumatic pneumothorax—the condition of the lungs and the size of the needle used—only the latter can be varied. The smaller needle, resulting in less trauma, gives a smaller collapse. In sixtyseven initial pneumothoraces, the collapse obtained with a large (No. 19) needle was approximately twice that noted with a small needle. 6) With moderate pulmonary involvement the size of the needle is of minor importance since excessive collapse and dyspnoea are uncommon. 7) However, in extensive disease the use of a large needle frequently results in marked collapse, often accompanied by severe dyspnoea, requiring deflation. In 16 bilateral cases in which pneumothorax was induced with a small needle, 3 became dyspnoeic, 1 requiring deflation. In 14 similar cases induced with a large needle, 8 became dyspnoeic and 4 of these required deflation. In patients with extensive disease, the dangers of induction of the initial pneumothorax may be minimized by the use of a small-gauge needle. In bilateral cases, its use appears essential if a manageable collapse is to be obtained." @default.
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• W1979591389 date "1948-07-01" @default.
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• W1979591389 title "The Role of Trauma in Initial Pneumothorax" @default.
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• W1979591389 doi "https://doi.org/10.1378/chest.14.4.475" @default.
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