Monday, September 10, 2007

intermittent oxygen in hydropneumothorax with Bronchopleural fistula(BPF)?

Here is an interesting question submitted by "zolt"

OK we all know that oxygen accelerates the rate of absorption of pneumothorax by about 4 times and so is of value in patients with pneumothorax being managed conservatively. Now in patients with hydropneumothorax with collapse with BPF with tube thoracostomy, is there any role of intermittent oxygen? how will be the diffusion mechanics in such patients or will all the oxygen come out through BPF?

3 comments - CLICK HERE to read & add your own!:

Anonymous said...

I guess if you already have a tube and the space has been decompressed, the O 2 should not impact improvement. The FiO2 will not change the flow through the BPF.

zolt said...

The lung has not re expanded completely.In such a scenario will giving intermittent oxygen help improve the patient's dyspnoea / hypoxemia .if so how will be the diffusion mechanics in such a lung? ie: will intermittent oxygen help in such patients?how?

Anonymous said...

Supplemental oxygen will improve this patients oxygenation, unless the collapse has resulted in a pure shunt which is almost never the case. The mechanism if increased oxygenation is simply the increased FiO2 in the alveolar gas equation (PaO2 = Fi02 x (Pb-PH20) - 0.8xPCO2).

Supplemental oxygen will not impact the DLCO, nor will it, in this case, facilitate resolution of the pneumothorax. The reason oxygen can facilitate the resolution of a pneumothorax is by replacing the nitrogen in ambient air with oxygen, which can then be absorbed. With a chest tube in place, that mechanism becomes irrelevant.