"Pre-procedure checks will identify patients at risk and rapid re-expansion should be prevented by the use of clamps or taps. Measured aspiration limited to 1-1.5 L/hour is safer than an underwater seal for large sub-acute pneumothoraces."
"Microvascular shearing forces during rapid re-expansion are thought to trigger neutrophil adhesion and activation, release of pro-inflammatory cytokines (such as TNF-α, IL-1β, and IL-8), and endothelial injury, which together cause disruption of the alveolar-capillary barrier and extravasation of protein-rich fluid into the alveolar spaces 8. Loss of surfactant, increased pulmonary artery pressures, and oxidative stress may exacerbate the condition."
Expected headings
"Risk factors"