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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Management of spontaneous pneumothorax-a Welsh survey. Diving and chronic spontaneous pneumothorax.

Quantification of pneumothorax size on chest radiographs pnsumothorax interpleural distances: Eur J Respir Dis. After treatment the patient should avoid physical exercise for 2—4 weeks and travelling by air for 2 weeks. Persistent air-leak in spontaneous pneumothorax–clinical course and outcome.

Spontaneous Pneumothorax – RCEMLearning

The pain radiates to the ipsilateral shoulder. Efficacy of the lateral decubitus position in preventing pneumothorax after needle biopsy of the lung.

Videothoracoscopic operation for secondary spontaneous pneumothorax. If conservative treatment is carried out in hospital, oxygen therapy may hasten the resorption of air from the pleural cavity.

Treatment Conservative treatment Conservative treatment follow-up by chest x-ray every 1—3 days is feasible in spontaneous pneumothorax if the following conditions are fulfilled: Any needle preferably a lneumothorax vein cannula can be used for urgent treatment of tension pneumothorax. A comparative study of the physiology and physics of pleural drainage systems. Signs of injury haematoma, crepitation from a broken rib, etc.


Br J Dis Chest. However, it is highly user dependent and for patients with suspected spontaneous pneumothoraces, radiography has the advantage of identifying unexpected causes of pleuritic pain eg infection, carcinoma.

Pleural suction is recommended in traumatic pneumothorax, collapsed lung, and in patients with severe dyspnoea.

This is probably a conservative figure. Copyright and License information Disclaimer. Does a thoracoscopic approach for surgical treatment of spontaneous pneumothorax represent progress?


Intercostal tube thoracostomy in pneumothorax–factors influencing re-expansion of lung. The symptoms will vary depending on the cause e.

Other catheters can be used if they have several holes in the last 10 cm of the catheter tip. Small drains eg FG have been shown to be associated with fewer complications particularly subcutaneous emphysema without prolonging time to resolution Pathophysiology, diagnosis, and management.

Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline

The most useful investigation is the PA chest radiograph despite the fact that it tends to under-estimate the size of a pneumothorax by virtue of it being a 2-dimensional image of a 3-dimensional structure. Surgical treatment should be bhs after the second episode at the latest. Traumatic pneumothorax Penetrating trauma of the chest, rib fracture, increased intrathoracic pressure in association with another injury Iatrogenic pneumothorax 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.


Recurrence rates are similar at 7 days and 1 year compared to thoracostomy tube insertion In such cases the pleural space should be drained at the mid- or posterior axillary pneumothoraax in the sixth intercostal space the nipple is usually situated on the fifth intercostal space with a larger French 20—24 catheter.

Both techniques are low risk in experienced hands. Occurs most frequently in men aged 20—40 years and in tall, thin persons.

BTS guidelines for the management of spontaneous pneumothorax

Evidence for destruction of lung tissues during Pneumocystis carinii infection. Urgent treatment is essential. Management of intercostal drains.