Cargando…

Conservative management of a complete primary spontaneous pneumothorax

Large primary spontaneous pneumothorax (PSP) has traditionally been managed with needle aspiration, chest tube drainage and, in refractory cases, thoracic surgery. A recent randomized trial, however, provided evidence that a conservative observational approach was safe and 85% of patients recovered...

Descripción completa

Detalles Bibliográficos
Autores principales: Jayawardena, Thisuri, Krivinskas, Sophie, Lee, Y. C. Gary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390567/
https://www.ncbi.nlm.nih.gov/pubmed/34471541
http://dx.doi.org/10.1002/rcr2.837
_version_ 1783743113872801792
author Jayawardena, Thisuri
Krivinskas, Sophie
Lee, Y. C. Gary
author_facet Jayawardena, Thisuri
Krivinskas, Sophie
Lee, Y. C. Gary
author_sort Jayawardena, Thisuri
collection PubMed
description Large primary spontaneous pneumothorax (PSP) has traditionally been managed with needle aspiration, chest tube drainage and, in refractory cases, thoracic surgery. A recent randomized trial, however, provided evidence that a conservative observational approach was safe and 85% of patients recovered without requiring pleural drainage interventions. A conservative approach provided similar re‐expansion rates at 8 weeks compared with chest tube drainage and offered the advantages of early hospital discharge, fewer days off work and avoidance of procedural risks. Nonetheless, clinicians are understandably anxious with conservative (non‐drainage) management for patients with very large pneumothorax. Here, we report a patient with a right‐sided PSP and total lung collapse that was managed successfully without intervention with minimal time in hospital or off work.
format Online
Article
Text
id pubmed-8390567
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley & Sons, Ltd
record_format MEDLINE/PubMed
spelling pubmed-83905672021-08-31 Conservative management of a complete primary spontaneous pneumothorax Jayawardena, Thisuri Krivinskas, Sophie Lee, Y. C. Gary Respirol Case Rep Case Reports Large primary spontaneous pneumothorax (PSP) has traditionally been managed with needle aspiration, chest tube drainage and, in refractory cases, thoracic surgery. A recent randomized trial, however, provided evidence that a conservative observational approach was safe and 85% of patients recovered without requiring pleural drainage interventions. A conservative approach provided similar re‐expansion rates at 8 weeks compared with chest tube drainage and offered the advantages of early hospital discharge, fewer days off work and avoidance of procedural risks. Nonetheless, clinicians are understandably anxious with conservative (non‐drainage) management for patients with very large pneumothorax. Here, we report a patient with a right‐sided PSP and total lung collapse that was managed successfully without intervention with minimal time in hospital or off work. John Wiley & Sons, Ltd 2021-08-26 /pmc/articles/PMC8390567/ /pubmed/34471541 http://dx.doi.org/10.1002/rcr2.837 Text en © 2021 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Case Reports
Jayawardena, Thisuri
Krivinskas, Sophie
Lee, Y. C. Gary
Conservative management of a complete primary spontaneous pneumothorax
title Conservative management of a complete primary spontaneous pneumothorax
title_full Conservative management of a complete primary spontaneous pneumothorax
title_fullStr Conservative management of a complete primary spontaneous pneumothorax
title_full_unstemmed Conservative management of a complete primary spontaneous pneumothorax
title_short Conservative management of a complete primary spontaneous pneumothorax
title_sort conservative management of a complete primary spontaneous pneumothorax
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390567/
https://www.ncbi.nlm.nih.gov/pubmed/34471541
http://dx.doi.org/10.1002/rcr2.837
work_keys_str_mv AT jayawardenathisuri conservativemanagementofacompleteprimaryspontaneouspneumothorax
AT krivinskassophie conservativemanagementofacompleteprimaryspontaneouspneumothorax
AT leeycgary conservativemanagementofacompleteprimaryspontaneouspneumothorax