PNEMOTHORAX;

INCIDENCE AND OUTCOMES OF PNEUMOTHORAX IN CRITICALLY ILL PATIENTS

Abstract

Objectives: To determine the incidence and outcomes of pneumothorax in
critically ill patients admitted in intensive care unit (ICU). Study Design: Retrospective study.
Setting: Intensive care unit of Nishtar Hospital Multan. Period: 1 July, 2016 to 31 Dec, 2016.
Methods: Included analysis of 300 patients. Patients of all age groups and gender were included
in this analysis. We reviewed their clinical records regarding age, gender, incidence and type of
pneumothorax, pneumothorax episodes and its causes. Diagnosis of pneumothorax was based
on clinical examination and plain chest X-rays of patients. Results: Pneumothorax occurred only
in 26 (8.7%) patients. Out of these 26 patients, there were 3 (1.0%) patients in whom spontaneous
pneumothorax occurred and in remaining 23 (7.7%) patients pneumothorax was iatrogenic in
nature. There was significantly higher rate of mortality in patients who developed pneumothorax
38.46%versus 3.2% in patients without pneumothorax (p-value <0.001). Duration of ICU stay
was also significantly prolonged in pneumothorax patients 11.4 days versus only 6.2 days
in patients without pneumothorax (p-value <0.001). Patients with iatrogenic pneumothorax,
mortality occurred in 5 (83.3%) patients in whom pneumothorax occurred due to mechanical
ventilation, 1 (33.3%) in patients with central venous catheter insertion, 2 (22.3%) in patients with
pericardiocentesis and 2 (40.0%) in patients with thoracentesis. Conclusion: Pneumothorax is
associated with a very high mortality and increased length of ICU stay. Mortality rate is higher
in pneumothorax due to mechanical ventilation (barotrauma) as compared to other procedure
related pneumothoraxes.