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Original Contribution

Nitrogen washout therapy for pneumothorax

Diane A. Butler, M.D. and James P. Orlowski, M.D.
Cleveland Clinic Journal of Medicine September 1983, 50 (3) 311-315;
Diane A. Butler
Pediatric Services, Inc., Parma Heights, OH
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James P. Orlowski
Department of Pediatric and Adolescent Medicine, The Cleveland Clinic Foundation.
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ABSTRACT

Three episodes of bilateral spontaneous nontension pneumothoraces in 2 adolescents with malignancies who refused chest tube placement were treated with a high concentration of inspired oxygen (FiO2 approaching 100%) administered via a tight-fitting nonrebreathing oxygen reservoir mask. This technique of nitrogen washout is a useful, noninvasive method for the reduction of noncritical pneumothoraces, which may obviate the necessity for more invasive procedures, although it has no place in the treatment of pneumothorax causing cardiopulmonary compromise. Two physiologic principles are involved. Breathing a high inspired FiO2 causes nitrogen to be washed out of the alveoli, venous blood, body tissues, and body cavities; this is known as “nitrogen washout.” Second, a great decrease in total tissue gas tension while breathing a high inspired FiO2 facilitates absorption of all gas from a closed body space.

Index terms
  • Nitrogen
  • washout therapy
  • Oxygen
  • therapy
  • Pneumothorax
  • Received April 1983.
  • Accepted June 1983.
  • Copyright © 1983 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 50 (3)
Cleveland Clinic Journal of Medicine
Vol. 50, Issue 3
21 Sep 1983
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Nitrogen washout therapy for pneumothorax
Diane A. Butler, James P. Orlowski
Cleveland Clinic Journal of Medicine Sep 1983, 50 (3) 311-315;

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Nitrogen washout therapy for pneumothorax
Diane A. Butler, James P. Orlowski
Cleveland Clinic Journal of Medicine Sep 1983, 50 (3) 311-315;
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