The evaluation of procedure and treatment outcome in patients with tension pneumothorax.

Introduction: Tension pneumothorax is a directly criti- cal illness condition. The aim of this study was to evaluate the outcome of tension pneumothorax treatment in trauma patients.

Material and methods: We assessed the results of treat- ment of 22 patients hospitalized for trauma in 2000-2010, in whom at the time of admission tension pneumothorax symptoms were found. This constituted 18% of trauma patients who at the time of admission to the hospital, during the initial examination, were diagnosed with pneumothorax. In the study group there were 17 men and 5 women. The patients' ages ranged from 21 to 85 years (mean 48.8). In 19 cases tension pneumothorax was associated with polytrauma. Traffic accidents were the cause of most cases. Injury to one or both lungs was observed in 16 patients. Typical paradoxi- cal breathing occurred in 2 patients. The number of frac- tured ribs averaged 6.3 per patient. In each of the patients, immediately on admission, after diagnosis based on clini- cal symptoms, tension pneumothorax decompression was performed by pleural drainage. Lung decompression and improvement of the clinical condition of the patient were obtained in a few minutes after pleural drainage. Then, fur- ther diagnostic and therapeutic procedures were continued. Full time of hospitalization due to polytrauma injury was on average 58.6 days. Two patients died during treatment for polytrauma. Pneumothorax was not the cause of death in either of the patients.

Conclusion: In summary, the therapeutic standard ordering of tension pneumothorax decompression, directly on admission to the hospital, allows the patient to survive in spite of the grave nature of the injury.