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Kioumis IP, Zarogoulidis K, Huang H, Li Q, Dryllis G, Pitsiou G, Machairiotis N, Katsikogiannis N, Papaiwannou A, Lampaki S, Porpodis K, Zaric B, Branislav P, Mpoukovinas I, Lazaridis G, Zarogoulidis P. Pneumothorax in cystic fibrosis. J Thorac Dis 2014; 6:S480-7. [PMID: 25337406 DOI: 10.3978/j.issn.2072-1439.2014.09.27] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 09/01/2014] [Indexed: 12/15/2022]
Abstract
Pneumothorax is recognized as a common and life-threatening complication in cystic fibrosis (CF) patients, especially in those who are infected with P. aeruginosa, B. cepacia or Aspergillus, need enteral feeding, are diagnosed as suffering from allergic bronchopulmonary aspergillosis (ABPA), developed massive hemoptysis, and their respiratory function is seriously compromised. Structural impairment and altered airflow dynamics in the lungs of CF patients are considered as the main predisposing factors, but also inhaled medications and non-invasive positive pressure ventilation (NIPPV) could increase the risk of pneumothorax. Clinical presentation could range from dramatic to very mild. Management of spontaneous pneumothorax occurring to patients with CF is essentially similar to that for non-CF patients. Therapeutic options include intercostal tube drainage, video-assisted thoracoscopic surgery (VATS), and medical or surgical pleurodesis. Pneumothorax increases both short- and long-term morbidity and mortality in CF patients and causes significant deterioration of their quality of life.
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Affiliation(s)
- Ioannis P Kioumis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Konstantinos Zarogoulidis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Haidong Huang
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Qiang Li
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Georgios Dryllis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Georgia Pitsiou
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Nikolaos Machairiotis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Nikolaos Katsikogiannis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Antonis Papaiwannou
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Sofia Lampaki
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Konstantinos Porpodis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Bojan Zaric
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Perin Branislav
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Ioannis Mpoukovinas
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - George Lazaridis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
| | - Paul Zarogoulidis
- 1 Pulmonary Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai 200438, China ; 3 Hematology Department, "Laiko" University General Hospital, Athens, Greece ; 4 Obstetric-Gynecology Department, "Thriassio" General Hospital of Athens, Athens, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 6 Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, Faculty of Medicine, University of Novi Sad, Serbia; 7 Oncology Department, "Biomedicine" Private Hospital, Thessaloniki, Greece ; 8 Oncology Department, "Papageorgiou" General Hospital, Thessaloniki, Greece
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