Spontaneous Pneumothorax in U.S. Army Aircrewmembers: Review, Management, and Disposition.

摘要

Spontaneous pneumothorax is a common clinical entity with a reported incidence of 0.005 to 0.05% that occurs most often in healthy young adult (50% between 20 to 29 years of age) males (85%) as a result of ruptured subpleural blebs. A single episode of spontaneous pneumothorax is not usually considered a grave therapeutic problem (mortality <1%) in nonflying personnel. It raises immediate concern in aircrewmembers, however, where its occurrence can affect an individual's ability to control an aircraft, particularly during high altitude and night nap-of-the-earth flight. This takes on added significance in light of the reported high incidence (50%) of recurrence. The US Army Aeromedical Activity Data Repository files were reviewed for the age, precipitating factors, recurrence rate, signs and symptoms, management, and disposition of the 12 identified cases of spontaneous pneumothorax on file in the data repository. The cases characteristically involved young (28.0 + or - 1.7 years) tall (70.6 inches) males presenting with acute chest pain and dyspnea. The etiology, pathophysiology, signs and symptoms, incidence, recurrence, and management are reviewed. Recommendations for the management and disposition of the US Army aviators with spontaneous pneumothorax are provided. (Author)