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Table 1 Suggested differences in clinical manifestations among patients with a tension pneumothorax stratified by presenting respiratory status[1, 7, 17, 22, 25]

From: Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

Respiratory status Predominant signs and symptoms Arterial blood pressure Method of arrest Time from presentation or pleural injury to arrest Rationale
Breathing unassisted Chest pain, dyspnea, respiratory distress, tachypnea, hypoxia and/or increased oxygen requirements, increased respiratory effort and contralateral respiratory excursions, tachycardia Normal until respiratory arrest or development of decreased level of consciousness (that is, until compensatory mechanisms fail) Respiratory Hours Compensatory mechanisms to progressively increasing ipsilateral pneumothorax size maintain arterial blood pressure until the pre-terminal stages of the disorder
Positive pressure ventilation Hypoxia and/or increased oxygen requirements, tachycardia, hypotension, and cardiac arrest Substantially decreased from normal Cardiac Minutes Absence of compensatory mechanisms to progressively increasing ipsilateral pneumothorax size allow for a rapid and significant decline in arterial blood pressure