BTS Pleural Guideline Group ii18 Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline A MacDuff, A Arnold. Guidelines for the management of spontaneous pneumothorax. Standards of Care Committee, British Thoracic Society. BMJ. Jul 10;()– Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline MacDuff A(1), Arnold A, Harvey J; BTS Pleural Disease .

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Treatment of complicated spontaneous pneumothorax by simple talc pleurodesis under thoracoscopy and local anaesthesia. If conservative treatment is carried out in hospital, oxygen therapy may hasten the resorption of air from the pleural cavity.

See our privacy policy for more information on what cookies are, how we use them and how to change your preferences. It should be remembered that narrower cannulae are also shorter and may not be long enough to reach the thoracic cavity in larger patients.

Preventive antibiotic usage in traumatic thoracic injuries requiring closed tube thoracostomy. The risk of pneumothorax recurrence increases in pregnancy and conveys a significant risk to both the mother and foetus. Parietal pleurectomy for recurrent spontaneous pneumothorax. Role of CT in the management of pneumothorax in patients with complex cystic lung disease. Indications, technique, management and complications. Following successful aspiration, patients with secondary pneumothoraces should be admitted for observation.

Insert the pnwumothorax in to the pleural space without force.

Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline

The presence of lung markings beyond the line in question, repeating the films with possible artefacts removed or comparison to previous films usually clarifies the situation. The clinical findings can be normal in a small pneumothorax. Operative pleurodesis in spontaneous pneumothorax. Catheter aspiration for simple pneumothorax. If the pneumothorax is recurrent or the patient has a high risk vocation, referral for a cardiothoracic outpatient appointment is appropriate.


This triangle is formed by the anterior border of latissimus dorsi posteriorly, the lateral aspect of pectoralis major anteriorly, and the 6th rib inferiorly forming an apex below the axilla. Other catheters can be used if they have several holes in the last 10 cm of the catheter tip.

Diagnosis A chest x-ray preferably posteroanterior, standing or guideoines examination is always necessary to confirm the diagnosis.

Spontaneous Pneumothorax

Earlier application of suction is not recommended because of concerns over precipitating re-expansion pulmonary oedema, which conveys a significant mortality risk Chest drain suction high volume, low pressure should be considered when lung re-expansion has not occurred pnehmothorax hours after chest drain insertion, which is suggestive of an ongoing air leak.

Aspiration has even been recommended as the treatment of choice for all types of pneumothorax. Different guidelines have been adopted by other bhs bodies This procedure should only be performed by a person trained and signed off as competent to do so. Videothoracoscopic operation for secondary spontaneous pneumothorax. The main indication for performing additional views would be where a secondary pneumothorax is suspected as identification of even a small pneumothorax in this setting may significantly influence management.

Distribution of mechanical stress in the lung, a possible pneuomthorax in localisation of pulmonary disease. Pleurodesis using talc slurry. Results of a Department of Veterans Affairs cooperative study.


Role of small calibre chest tube drainage for iatrogenic pneumothorax. Pleural abrasion via axillary thoracotomy in the era of video assisted thoracic surgery.

Recurrence rates are similar at 7 days and 1 year compared to thoracostomy tube insertion The symptoms do not correlate closely with the size pneumothoarx the pneumothorax Br J Hosp Med.

Spontaneous Pneumothorax – RCEMLearning

Surgical management of pneumothorax in patients with acquired immunodeficiency syndrome. It is safest to make an incision with a lancet and then use the finger to make the way to the pleural space. These are solid objects and on the left side the apex of the heart lies close to the insertion point!

If the lung is not inflated insert another drain. Respiratory gas exchange in patients with spontaneous pneumothorax. It is advised that 2 weeks have elapsed following confirmed resolution if the pneumothorax was traumatic pneumpthorax origin, which corresponds to the advice issued by the UK civil aviation authority. Results of simple aspiration of pneumothoraces. This is probably a conservative figure.

The efficacy and timing of operative intervention for spontaneous pneumothorax. Clinical signs Suppressed or missing respiratory sounds, impaired chest mobility, and hollow echoing hypersonoric guidelijes sounds are often observed.

Both techniques are low risk in experienced hands. The diagnosis is made by the visualising the visceral pleura guiedlines edge separated from the thoracic cage with no visible lung marking between the two.