A study on clinical and arterial blood gas parameters before and after tube thoracostomy among cases of primary and secondary spontaneous pneumothorax

Abstract

Pneumothorax is a common respiratoryemergency that requires active interventions in many cases specially Tube thoracostomy. Objective of the present study is to find out changes in clinical and arterial blood gas parameters in primary and secondary pneumothorax following tube thoracostomy at different time intervals.Total 30 cases, Primary spontaneous pneumothorax (PSP) 11 and secondary spontaneous pneumothorax (SSP) 19. Clinical parameters: pulse rate, blood pressure, respiratory rates, oxygen saturation (SpO2). ABG analysis: pH, partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), AaDO2. Time interval: pre tube thoracostomy, 1hour and 24hours after thoracostomy and after tube removal. PSP was found more in young patients (mean 34.18), SSP in older patient (mean 52.68), (P=0.001). Among clinical parameters statistically significant changes were seen in pulse rate, (P<0.001) respiratory rate (P<0.001) in both groups, in both cases tachycardia and tachypnea decreased. Diastolic blood pressure in SSP group (P<0.01), SO in SSP group (P<0.05). There is an increase in mean arterial pressure from pre thoracostomy compared to in 1hr, 24hr and at removal. Which statistically significant in SSP group.In PSP group hypoxaemia was present in 54.54% patients before giving chest tube, after 1 hour of tube thoracostomy only 18.18% cases had mild hypoxaemia. In SSP group 68.42% cases presented with hypoxaemia initially, after tube removal 26.31% cases had mild hypoxaemia.No significant changes in other blood gas parameters were seen in either groups. The impact of tube thoracostomy on primary and secondary pneumothorax are mainly reflected on clinical parameters rather than blood gas parameters.