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Pneumothorax   in  ICU ,[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
ICU pts : High Risk Group  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
De Lassence et al  Anesthesiology. 2006 Jan;104(1):5-13.   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pneumothorax in the intensive care unit: incidence & risk factors,
Close  Associations  for high incidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types/ Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spontaneous Pneumothorax  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How Mechanical Ventilation Responsible for Pneumothorax ?
Biotrauma Barotrauma and Volutrauma Atelectrauma
Barotrauma and Volutrauma ,[object Object],[object Object]
[object Object],[object Object]
 
Relationship between ventilatory settings and barotrauma in the ARDS   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Mohamed Boussarsar  Intensive Care Med. 2002 ;28 (4):406-13.
Pneumothorax Traumatic/ Procedure related  ,[object Object],[object Object],[object Object],[object Object]
Pneumothorax; Central Venous Line ,[object Object],[object Object],[object Object],[object Object],Ruesch S, Walder B, Tramer M. Complications of Central Venous Catheters: Internal Jugular versus Subclavian access-A Systematic Review. Crit Care Med. 2002;30:454-60.
Pneumothorax after insertion of central venous catheters in the intensive care unit: association with month of year and week of month ,[object Object],[object Object],Najib T Ayas- Quality and Safety in Health Care  2007; 16 :252-255
Symptoms ,[object Object],[object Object]
Tension Pneumothorax ,[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical picture ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology of symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations A A A A A
Hallmark: air between two pleural spaces ,[object Object],[object Object],[object Object],[object Object],[object Object]
Distribution of air
Always look for…. ,[object Object],[object Object],[object Object]
Role of Ultrasound in Diagnosis ,[object Object],[object Object],[object Object]
CT Thorax
Pneumothorax Prevention during CVCs ,[object Object],[object Object],[object Object],[object Object]
Ultrasound Guided CVCs ,[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tension pneumothorax; Treatment  ,[object Object],[object Object],[object Object],[object Object]
Thoracostomy (Chest tube)
Pulmonary blebs ,[object Object],[object Object],[object Object]
complications of air of pleural parenchyma ,[object Object],[object Object],[object Object],[object Object]
Prognosis ,[object Object]
Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prognosis contd.. ,[object Object],[object Object],[object Object]
Conclusion
 
Twist in Tale..
CXR with recurrent right-sided pneumothorax, despite thoracostomy tube in place CT scan with giant bullae and anterior pneumothorax after insertion of a second thoracostomy tube
Message ,[object Object],[object Object],[object Object],[object Object]
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pneumothorax in ICU