Dean Cruikshank


Approximately 5-20% of people with CF may develop what is called a pneumothorax or collapsed lung. This occurs when air leaks out of the lungs and collects in the space around the lungs. This collection of of air can put pressure on the lung, so it cannot expand as much as it normally does when you take a breath. It can also put pressure on the heart and blood vessels. This situation can be life threatening and needs to be dealt with quickly.  This condition is confirmed by a chest x-ray. 

Most people with a pneumothorax will experience worsening shortness of breath and chest pain, particularly with deep breathing.  Although anyone with CF can develop a pneumothorax, those at highest risk are individuals with low lung function (FEV1 < 30% predicted), or those with a previous history of a pneumothorax.  If you experience these symptoms it is important to call your CF team because you may need to see your doctor and get a chest x-ray.  If you are extremely short of breath, you should go to the nearest emergency department. Some forms of airway clearance therapy may not be safe for individuals that have been diagnosed with a pneumothorax. It is still important to maintain an airway clearance regimen to keep the lungs as healthy as possible, but a change in technique may be necessary. There are currently no scientific studies that have looked at airway clearance and pneumothorax. The guidelines below are based on expert opinions and consensus.

What to do if you suspect you are having a pneumothorax

If you suspect you may have a pneumothorax, in addition to calling your CF team or coming to emergency, you should:
• Stop airway clearance
• Avoid forceful coughing
• Try gentle coughing and huffing
• Stop exercise

Once you have seen a doctor and been treated for a pneumothorax ,then:
• Try gentle coughing and huffing
• Avoid upper limb strengthening exercises
• Gentle exercise (walking, gentle cycling)
• Avoid PEP or oscillating PEP therapy for 1-2 weeks once you have completed the treatment

If this complication should occur, your physiotherapist will assist you in coming up with a safe and effective treatment plan.