How does scuba diving cause pneumothorax?

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From the Guidelines

Scuba diving can cause pneumothorax through barotrauma, which occurs when pressure changes damage lung tissue, and individuals with a history of spontaneous pneumothorax or known lung cysts should avoid scuba diving altogether due to the significantly higher risk of this potentially life-threatening complication. During ascent, air in the lungs expands as surrounding water pressure decreases, and if a diver holds their breath or has air trapped in their lungs due to conditions like asthma or blebs (weak spots in lung tissue), this expanding air can rupture alveoli and allow air to escape into the pleural space between the lung and chest wall, creating a pneumothorax, where the lung partially or completely collapses 1. Symptoms include sudden chest pain, shortness of breath, and in severe cases, respiratory distress. Prevention involves proper training, controlled ascent rates (never exceeding 30 feet per minute), continuous breathing during ascent, and avoiding diving with respiratory conditions that increase risk, such as asthma, COPD, or cystic fibrosis 1.

Some key points to consider in the prevention of pneumothorax during scuba diving include:

  • Avoiding diving with respiratory conditions that increase risk, such as asthma or COPD
  • Ensuring proper training and controlled ascent rates
  • Continuous breathing during ascent
  • Avoiding diving with a history of spontaneous pneumothorax or known lung cysts
  • Monitoring lung function and performing regular check-ups to identify any potential risks 1.

It is essential to prioritize the safety of the diver and take necessary precautions to prevent pneumothorax, as it can be a life-threatening complication. By following these guidelines and taking a cautious approach, divers can minimize their risk of developing pneumothorax and ensure a safe and enjoyable diving experience.

From the Research

Causes of Pneumothorax in Scuba Diving

Pneumothorax, also known as a collapsed lung, can occur in scuba diving due to various factors. The following are some of the possible causes:

  • Lung overexpansion during ascent from depth, which can cause lung barotrauma 2
  • Breath holding during ascent, which can lead to pulmonary barotrauma and air embolism 3
  • Gas trapping due to disease, causing lung hyperexpansion and rupture 3
  • Voluntary diaphragmatic contractions during ascent, which can contribute to alveolar hemorrhage and pneumothorax 4
  • Emergency ascent from shallow depth, which can cause bilateral barotrauma of the lungs, air embolism, and pneumothorax 5

Mechanism of Pneumothorax

The mechanism of pneumothorax in scuba diving is related to the effects of Boyle's law, which states that the volume of a gas is inversely proportional to the pressure. During ascent, the decrease in pressure can cause the gas in the lungs to expand, leading to lung overexpansion and barotrauma 2. This can result in a pneumothorax, which is the presence of air or gas in the pleural cavity.

Risk Factors

Certain individuals may be more susceptible to pneumothorax while scuba diving, including those with pre-existing medical conditions such as chronic spontaneous pneumothorax 6. It is essential for divers to undergo medical clearance before diving to assess their fitness to dive and minimize the risk of pneumothorax and other diving-related disorders 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diving medicine.

American journal of respiratory and critical care medicine, 2014

Research

Neurology and diving.

Handbook of clinical neurology, 2014

Research

Air embolism with bilateral pneumothorax after a five-meter dive.

Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc, 1993

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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