Principles of diagnosis and management of tension pneumothorax: A literature review

Abstract

Tension pneumothorax is the most severe form of pneumothorax and constitutes a medical emergency that can be life-threatening if not promptly recognized and managed. This condition is characterized by the progressive accumulation of air in the pleural cavity due to a one-way valve mechanism, leading to increased intrathoracic pressure, mediastinal shift, decreased venous return, obstructive shock, and ultimately cardiac arrest. This literature review aims to provide a comprehensive understanding of the principles of diagnosis and management of tension pneumothorax. A literature search was conducted using PubMed, Cochrane Library, ScienceDirect, and ProQuest with keyword combinations of diagnosis, management, and tension pneumothorax. Diagnosis should be made clinically without waiting for radiological confirmation, especially when patients present with symptoms such as shortness of breath, chest pain, tachypnea, hypotension, decreased unilateral breath sounds, hyperresonance on percussion, tracheal deviation, and distended neck veins. Initial management includes the administration of high-concentration oxygen and immediate needle decompression, followed by chest tube insertion as definitive therapy. The accuracy and speed of diagnosis and emergency intervention are crucial in reducing the mortality associated with tension pneumothorax.