Table 1 Suggested differences in clinical manifestations among patients with a tension pneumothorax stratified by presenting respiratory status[1, 7, 17, 22, 25]
From: Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis
Respiratory status | Predominant signs and symptoms | Arterial blood pressure | Method of arrest | Time from presentation or pleural injury to arrest | Rationale |
|---|---|---|---|---|---|
Breathing unassisted | Chest pain, dyspnea, respiratory distress, tachypnea, hypoxia and/or increased oxygen requirements, increased respiratory effort and contralateral respiratory excursions, tachycardia | Normal until respiratory arrest or development of decreased level of consciousness (that is, until compensatory mechanisms fail) | Respiratory | Hours | Compensatory mechanisms to progressively increasing ipsilateral pneumothorax size maintain arterial blood pressure until the pre-terminal stages of the disorder |
Positive pressure ventilation | Hypoxia and/or increased oxygen requirements, tachycardia, hypotension, and cardiac arrest | Substantially decreased from normal | Cardiac | Minutes | Absence of compensatory mechanisms to progressively increasing ipsilateral pneumothorax size allow for a rapid and significant decline in arterial blood pressure |