Re-Expansion of the Artificial Pneumothorax Lung

¹ Chest Clinician, Toronto Western Hospital, Toronto, Canada.
² Chief Clinician, Toronto Western Hospital, Toronto, Canada.

1) A considerable number of pneumothoraces, in this series, 36 per cent were discontinued because of the occurrence of various complications, and before the operator would otherwise choose to allow re-expansion.

2) A rather high percentage of pneumothoraces optionally discontinued, ended with evidence of pleural thickening or mediastinal shift.

3) In this series only 44 per cent re-expanded fully without x-ray evidence of pleural thickening or mediastinal shift.

4) Although the functional impairment in the cases in this series with pleural thickening or mediastinal shift was probably not severe it seems desirable to minimize the occurrence of such changes if possible.

5) Some evidence is presented that the high negative pressures of the re-expansion period are responsible for the occurrence of pleural thickening and for mediastinal shift.

6) It is suggested that re-expansion should be gradual, i. e. that pneumothorax refills should not be stopped suddenly but should be tapered off.