Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

MacDuff, Andrew; Arnold, Anthony; Harvey, John

doi:10.1136/thx.2010.136986

Cited by 1,189 publications

(1,549 citation statements)

References 222 publications

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“…Otherwise aspiration can be performed; chest tube insertion being reserved for those with a persistent air leak. Patients with incomplete lung expansion after chest tube placement, bilateral pneumothoraces, recurrent pneumothorax or a hemopneumothorax require thoracotomy or VATS [11]. Optimal time for surgical management is during the second trimester.…”

Section: Discussionmentioning

confidence: 99%

“…Chemical pleurodesis is also an option as a definitive management of recurrent pneumothorax with talc pleurodesis resulting in lowest recurrence rate [12]. Further, post-convalescence VATS procedure decreases the recurrence risk of pneumothorax in subsequent pregnancies, as successful pregnancies and spontaneous deliveries without pneumothorax recurrence have been reported in patients who underwent the procedure [11]. Our patient had her baby when she had the third chest tube in place, we believe that the delivery mitigated the pregnancy-related respiratory changes of the patient; thus, making the chest tube sufficient to treat the recurrence of the pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…Also, nitrous oxide for intrapartum pain relief can compromise patient safety and is contraindicated, as it can cause and exacerbate a tension pneumothorax [13]. From previous data, the optimal mode of delivery will usually be that of elective assisted delivery (forceps or ventouse extraction) at or near term, with regional (epidural) anaesthesia [11]. Instrumental deliveries shorten the second stage of labour and thus reduce maternal expulsive efforts [8].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent spontaneous pneumothorax in pregnancy – a case report and review of literature

Lateef

Dawood

Sharma

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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Spontaneous pneumothorax in pregnancy is a rare and life-threatening condition. In this report, a case of spontaneous pneumothorax occurring at 34 weeks’ gestation in a healthy 34-year-old primigravida is described. She had typical complaints of chest pain and dyspnoea and diagnosis was made by chest X-ray which showed an extensive pneumothorax in the right side. Pneumothorax recurred twice over approximately three weeks. A caesarean section secondary to small pelvic parameters was scheduled with the chest tube in situ and a healthy 2.5 kg female infant was delivered. We discuss spontaneous pneumothorax during pregnancy and review the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Recurrent spontaneous pneumothorax in pregnancy – a case report and review of literature

Lateef

Dawood

Sharma

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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“…Other patients who warrant consideration for surgical management include patients with spontaneous pneumothorax with: prolonged air leak, incomplete lung expansion, bilateral pneumothorax, tension pneumothorax or blebs on CT imaging (10). Contraindications to a subxiphoid approach include high BMI, patients with cardiomegaly and reoperative procedures.…”

Section: Patient Selection and Workupmentioning

confidence: 99%

Subxiphoid approach for spontaneous bilateral pneumothorax: a case report

et al. 2017

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An 18-year-old man presented to the Emergency Department (ED) with sudden onset chest pain and a nonproductive cough. He had no significant past medical history or underlying pulmonary disease and there was no history of trauma preceding the onset of symptoms. On admission the patient was dyspnoeic and had decreased breath sounds over the right hemithorax. He was haemodynamically stable with oxygen saturation of 94% on room air. Complete blood count and biochemistry results were within normal Abstract: The development of video-assisted thoracoscopic surgery (VATS) has contributed to reduced pain and improved recovery following thoracic surgery. However, pain remains a major issue. Patients with bilateral pulmonary pathology requiring operative intervention may have even more pain due to bilateral transthoracic incisions. The recently described uniportal subxiphoid VATS approach provides an opportunity to undertake bilateral thoracic surgery through a single incision that avoids the bilateral intercostal nerve damage caused by transthoracic incision and drainage. Here we report a case of a patient requiring bilateral bullectomy and pleurectomy for the management of pneumothorax that was performed successfully by the subxiphoid VATS approach. limits. A chest radiograph demonstrated a large right sided pneumothorax which was treated with insertion of a 14 Fr Seldinger chest drain and resolved spontaneously during a 2-day admission and he was discharged home. One month later he presented to the ED with similar symptoms and at this time chest radiography demonstrated a left sided pneumothorax which was treated with insertion of a 14 Fr Seldinger chest drain but had a persistent air leak. Chest computed-tomography (CT) revealed multiple subcentimeter blebs of variable size in the apical portion of both lungs. He was referred to our tertiary cardiothoracic centre for consideration of surgical treatment. Patient selection and workupIndications for thoracoscopic pleurectomy and bullectomy include patients following a second ipsilateral spontaneous pneumothorax or a first contralateral pneumothorax. Other patients who warrant consideration for surgical management include patients with spontaneous pneumothorax with: prolonged air leak, incomplete lung expansion, bilateral pneumothorax, tension pneumothorax or blebs on CT imaging (10). Contraindications to a subxiphoid approach include high BMI, patients with cardiomegaly and reoperative procedures. InstrumentsStandard VATS instruments with dedicated instruments specially designed for SVATS [Shanghai Medical Instruments (Group) Ltd., Shanghai, China] are used during the operations (Figure 1). Surgical procedureA single staged bilateral surgical intervention was planned. The operation was performed with the patient under general anaesthesia and double lumen endotracheal tube intubation to allow for selective lung ventilation. Patient was placed in a left lateral decubitus position slightly rotated posteriorly in order to optimize exposure of the subxiphoid region for the lef...

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“…The British Thoracic Society recommends hospital admission for all patients with chest tubes and for all cases of secondary pneumothorax (even after successful aspiration) by these guidelines. 6 The American College of Chest Physicians published consensus guidelines for the management of spontaneous pneumothorax in 2001. 7 These guidelines match those of the British Thoracic Society in every way except that they do not endorse aspiration.…”

Section: Introductionmentioning

confidence: 99%

Global Emergency Medicine Journal Club: A Social Media Discussion About the Outpatient Management of Patients With Spontaneous Pneumothorax by Using Pigtail Catheters

Trueger¹,

Murray²,

Kobner³

et al. 2015

Annals of Emergency Medicine

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Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

Cited by 1,189 publications

References 222 publications

Recurrent spontaneous pneumothorax in pregnancy – a case report and review of literature

Recurrent spontaneous pneumothorax in pregnancy – a case report and review of literature

Subxiphoid approach for spontaneous bilateral pneumothorax: a case report

Global Emergency Medicine Journal Club: A Social Media Discussion About the Outpatient Management of Patients With Spontaneous Pneumothorax by Using Pigtail Catheters

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