How Do You Treat A Collapsed Lung? Complete Guide

A collapsed lung, known medically as a pneumothorax, happens when air leaks into the space between your lung and your chest wall. This air pushes against the outside of your lung, causing it to collapse partially or completely. The treatment depends entirely on how much of the lung has collapsed and whether your breathing is affected. Small collapses often heal on their own with observation, while larger collapses require a procedure to remove the trapped air. In severe cases, surgery is needed to prevent it from happening again.

What Exactly Causes a Collapsed Lung?

Air can enter the pleural space in a few different ways. The pleural space is the thin, fluid-filled area between the lung and the inner chest wall. When air gets into this space, it breaks the seal that keeps the lung expanded.

A spontaneous pneumothorax happens without any injury. It often occurs when a small air blister on the lung, called a bleb, ruptures. This is most common in tall, thin people, especially young men. Smoking also increases the risk significantly.

A traumatic pneumothorax results from a direct injury. This includes rib fractures, puncture wounds, or blunt force to the chest. Car accidents and falls are common causes.

Some medical procedures can cause a collapsed lung as a complication. Inserting a central line, a lung biopsy, or mechanical ventilation can accidentally puncture the lung. In these cases, the treatment follows the same principles.

How Do You Treat A Collapsed Lung Based on Severity?

Treatment is determined by the size of the collapse and your symptoms. A small pneumothorax with mild symptoms may only need oxygen therapy and monitoring. A large collapse or one that causes shortness of breath requires active intervention.

The medical team will assess the size of the collapse using a chest X-ray. They will also measure your oxygen levels and watch your breathing effort. Your age and overall lung health matter too. Someone with healthy lungs can tolerate a small collapse better than someone with chronic lung disease.

There are three main treatment paths: observation, needle aspiration, and chest tube drainage. Surgery is reserved for recurrent cases or when a chest tube fails.

Observation and Oxygen Therapy

If the collapse is small, meaning less than about 20 percent of the lung, and you are not short of breath, your doctor may recommend observation. The trapped air will slowly be reabsorbed by the body. This process can take several days to weeks.

Breathing supplemental oxygen can speed up this process. Oxygen helps the body absorb the trapped nitrogen in the pleural space faster. You may need to stay in the hospital for monitoring, or you may be sent home with clear instructions on what symptoms to watch for.

You will need a follow-up X-ray to confirm the lung has fully re-expanded. You should avoid flying and scuba diving until the lung is fully healed.

Needle Aspiration

For a moderate collapse, a doctor may use a needle to remove the air. This procedure is called needle aspiration. A needle is inserted into the chest between the ribs, and a syringe is used to pull out the trapped air.

This is often done in the emergency department. It can be effective for a first-time spontaneous pneumothorax. If the lung does not re-expand fully, a chest tube will be needed instead.

Chest Tube Drainage

A chest tube is the standard treatment for a large collapse or when breathing is difficult. This is a flexible plastic tube that is inserted between the ribs into the pleural space. The tube is connected to a drainage system that uses suction or a water seal to remove air and allow the lung to re-expand.

The procedure is done with local anesthesia and sedation. You will be awake but comfortable. The tube may stay in place for a few days. The medical team will monitor the drainage and take X-rays to check lung expansion. The tube is removed once the air leak stops and the lung is fully expanded.

When Is Surgery Needed for a Collapsed Lung?

Surgery is not the first treatment for a first-time pneumothorax. It is considered when a collapse happens again on the same side, when a chest tube fails to seal the air leak, or when both lungs have collapsed. It is also recommended for people in high-risk professions, such as pilots or divers, who cannot risk a recurrence.

The goal of surgery is to prevent future collapses. The surgeon identifies and removes the blebs that are likely to rupture. The surgeon also performs a procedure called pleurodesis. This creates inflammation in the pleural space, which causes the lung to stick to the chest wall. This eliminates the space where air can collect.

Pleurodesis can be done chemically or mechanically. In chemical pleurodesis, a substance is introduced through the chest tube to irritate the pleural lining. In surgical pleurodesis, the surgeon physically abrades the lining. Both methods have high success rates in preventing recurrence.

Most surgeries are now done using video-assisted thoracoscopic surgery, or VATS. This is a minimally invasive technique using small incisions and a camera. Recovery is faster than with traditional open surgery.

What Does Recovery Look Like After Treatment?

Recovery time depends on the treatment you received. If you were managed with observation alone, you can usually resume normal activities within a week. If you had a chest tube, expect a hospital stay of one to several days. Full recovery typically takes two to four weeks.

You will need to avoid heavy lifting and strenuous exercise during recovery. This allows the lung to heal and the pleura to seal properly. Your doctor will tell you when it is safe to resume these activities.

You should not fly in an airplane until your doctor confirms the lung has fully healed. Changes in cabin pressure can cause a small remaining air pocket to expand. This can lead to a recurrence. Scuba diving is also off-limits for the same reason, and often permanently, because of the high recurrence risk.

Smoking cessation is critical. Smoking greatly increases the risk of a spontaneous pneumothorax. The risk goes up with the number of cigarettes smoked. Quitting is the single most effective step you can take to prevent a recurrence.

What Are the Signs of a Collapsed Lung?

Recognizing the symptoms is important because a collapsed lung requires prompt medical attention. Symptoms typically come on suddenly. They can include sharp chest pain that worsens with breathing, shortness of breath, and a feeling of tightness in the chest.

Other symptoms may include a dry cough, fatigue, and rapid breathing. In severe cases, the skin may take on a bluish tint due to lack of oxygen. This is a medical emergency.

If you experience sudden chest pain and difficulty breathing, seek emergency care immediately. Do not wait to see if it passes. A tension pneumothorax is a life-threatening version where pressure builds up and shifts the heart. This requires immediate emergency treatment.

Can a Collapsed Lung Be Prevented?

Not every collapsed lung can be prevented. A spontaneous pneumothorax often happens without warning. However, you can reduce your risk factors where they exist.

Quitting smoking is the most important preventive measure. If you have already had a pneumothorax, quitting smoking reduces the chance of a second one. The recurrence rate for a first-time spontaneous pneumothorax is roughly 30 percent. That risk increases with continued smoking.

Avoiding rapid pressure changes is also relevant. Scuba diving is particularly risky for anyone who has had a pneumothorax. The pressure changes can cause a healed area to rupture again.

For people with a known family history of pneumothorax or connective tissue disorders, discussing screening with a doctor may be appropriate. Conditions like Marfan syndrome and Ehlers-Danlos syndrome are associated with higher risk.