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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Am J Emerg Med. Time course of resolution of persistent air leak in spontaneous pneumothorax. Open thoracotomy is rarely needed.

Onset of symptoms in spontaneous pneumothorax: Effect of clinical guidelines on medical guivelines The ribspace below the 2nd rib is the 2nd intercostal space.

Needle aspiration is less likely to succeed for secondary pneumothoraces 15 and is only recommended in this setting if the patient has a small pneumothorax cm in size and minimal symptoms. Surg Clin North Am. Symptoms Sharp chest pain, dyspnoea and cough irritation are the main symptoms.

Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax.

BTS guidelines for the management of spontaneous pneumothorax

J Thorac Cardiovasc Surg. Efficacy of the lateral decubitus position in preventing pneumothorax after needle biopsy of the lung. Traumatic pneumothorax Penetrating trauma of the chest, rib fracture, increased intrathoracic pressure in association with another injury Iatrogenic pneumothorxx Catheterizations, punctures and operations in the chest area; positive pressure ventilation Tension pneumothorax A one-way valve is formed in the pleural cavity, whereby air can enter the pleural cavity during inhalation but cannot exit from there.


Do not close the catheter.

Earlier application of suction is not recommended because of concerns over precipitating re-expansion pulmonary oedema, which conveys a significant mortality risk Video-assisted thoracoscopic pleurectomy in the treatment of recurrent spontaneous pneumothorax. If this is the case, then the patient should be advised to initially return to the Emergency Department for a repeat chest radiograph and senior doctor review at 2 weeks, pending specialist review.

Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Spontaneous pneumothorax with Pneumocystis carinii infection.

Both techniques are low risk in experienced hands.

Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline

There are two gujdelines depicting the recommended treatment algorithm for a primary and secondary spontaneous pneumothorax, these are available to download at the end of this module. Risk factors and treatment. Patients with spontaneous secondary pneumothoraces less than 1cm in size and minimal symptoms do not require drainage in the ED but should be admitted for observation and supplemental oxygenation.

Unlike symptoms, the examination findings in primary spontaneous pneumothoraces are affected by the size of the pneumothorax. Nd-YAG laser pleurodesis via thoracoscopy. Am Rev Pneumtohorax Dis.


In the last decade there has been a move toward inserting smaller drains percutaneously. A large emphysematous bulla may resemble pneumothorax and cause misinterpretation. Usually seen in trauma patients and in connection with mechanical ventilation and resuscitation. CT is considered the gold standard at identification of a pneumothorax and is particularly valuable when radiographs are difficult to interpret or specific drain placement is required eg bullous lung disease, loculated pneumothoraces, surgical emphysema.


Comparison of the effectiveness of tetracycline and minocycline as pleural sclerosing agents in rabbits. Patients discharged from the Emergency Department following a spontaneous pneumothorax should ideally be reviewed by a respiratory physician after 2 weeks. The efficacy and timing of operative intervention for spontaneous pneumothorax. Chest movement may be asymmetric.

Following successful aspiration, patients with secondary pneumothoraces should be admitted for observation. The patient has significant dyspnoea e.

Diagnosis and treatment of cystic fibrosis. This article has been cited by other articles in PMC. Talc poudrage in the treatment of spontaneous pneumothoraces in patients with cystic fibrosis.

Respiratory gas exchange in patients with spontaneous pneumothorax. Management of pneumothorax in cystic fibrosis. Copyright and License information Disclaimer. Treatment of AIDS-related spontaneous pneumothorax.

BTS guidelines for the management of spontaneous pneumothorax

In special cases a CT scan may be necessary diagnostic problems, planning of surgery, investigation of aetiology. The patient should contact the doctor immediately if the symptoms get worse.

Delayed referral reduces the success of video-assisted thoracoscopic surgery for spontaneous pneumothorax.