Chokes

The chokes is the air presence in the pleural cavity, the lungs are surrounded by a coat with two walls called pleura, the space between those walls is known like pleural cavity, this space facilitates the pulmonary movements during the breathing.

The effect of the chokes (this accumulated air) is the one that makes difficult the pulmonary gaseous interchange, even arriving at a pulmonary collapse.

Several types of chokes exist (are classified according to their etiología: cause)

       * Spontaneous: it is the air presence without a clear cause.

       * Traumatic: it is from a traumatic injury in the thorax, that can be penetrating, by hurt with cutting weapon or firearm, or forceful, as in the case of an impact because of an automobile accident (commonest).

  TRAUMATIC CHOKES
It is possible to be classified like open or closed, according to it exists communication with external means or not in:

a.       Simple N eumotórax Closed: The blunt trauma can create a closed chokes as resulting from fractures of ribs that would laceran the lung, although most of the cases of postraumático chokes, the etiología is the alveolar rupture or of the aerial routes in the most serious cases. This rupture is the reason for which it is lost air towards the plural cavity.

  b.       N eumotórax Opened: The penetrating trauma of the thorax by regulating causes chokes to abier to, this situation is more or less complicated depending on the size of the tóraco orifice of communication? atmospheric. The dog and the cat, unlike the man, have a very thin mediastinal pleura and fenestrada, so that an unilateral penetrating wound generates a b ilateral chokes, which determines partial or total collapse of both lungs. When the diameter of the orifice is equal or superior to the diameter of the trachea the pulmonary collapse is severe and the animal has serious difficulties to mobilize air and in general habra unemployment cardiorespiratorio in some minutes (5 to 10) after the accident Orifices of so large minor is compatible with the life, but they needed urgent veterinary attention

  Symptoms:

   * Toráxico pain 
   * Difficulty to breathe
   * Fatigue
   * Increased cardiac beats (tachycardia)
   * Mucous blue color (cyanosis)           

  Diagnosis:

· And l clinical picture of a patient affected by this type of chokes are dramatic, with breathing distressing, and difficult to a high frequency, frequently with cyanosis, etc. therefore, the diagnosis is eminently clinical or bservando the signs and symptoms before mentioned,

· Examination of the thorax with estetoscopio, to the auscultation the cardiac sounds can be difficult to listen; the pulmonary sounds diminished and the percussion of the thorax will be hyperresonant.

· Radiology is used to confirm the diagnosis, and to know the extension the damage. The clinical one must determine the suitable moment to make the study without putting in risk the life of the patient

Treatment:

In previously healthy animals, without another associated pathology, it is rare that a small and simple chokes implies vital risk, and will be important clinical commitment when the collapse degree is greater to 50%, since small the chokes can be solved by themselves.

The treatment of urgency of the chokes implies the fast decompression by means of a toracocentesis, that consists of the positioning of a torácico tube between the ribs within the pleural space that allows the evacuation of the air thence.  The lightening shown by the patient when air retiring a little is impressive, and this allows us to gain time like later placing a tube of torácico drainage that lasted several days, the veterinary doctor will repeat this maneuver with a decreasing frequency (each 2 to 4 hrs the first day) according to the evolution of the patient having obtained who the lung reexpanda, thus is required of hospitalization for the handling of this sounding.

?All the pictures of chokes benefit with the administration from I oxygenate?

Author: MV Adelaida A. Goldman

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