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    Pneumothorax management: current state of practice in the UK

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    Author
    Roberts, Mark
    Keyword
    Air leak
    Clamping
    Management
    Pneumothorax
    Suction
    Surgery
    Date
    2022-02
    
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    Show full item record
    Publisher's URL
    https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-022-01943-9
    Abstract
    Background and objective: Spontaneous pneumothorax is a common pathology but optimal initial treatment regime is not well defined. Treatment options including conservative management, needle aspiration (NA) or insertion of a small-bore chest drain. Recent large randomised controlled trials may change the treatment paradigm: comparing conservative and ambulatory management to standard care, but current guidelines need to be updated. The aim of this study was to assess the current "state of play" in the management of pneumothorax in the UK. Methods: Physicians and respiratory healthcare staff were invited to complete an online survey on the initial and subsequent management of pneumothorax. Results: This study is the first survey of pneumothorax practice across the UK, which highlights variation in practice: 50% would manage a large primary pneumothorax with minimal symptoms conservatively, compared to only 3% if there were significant symptoms; 64% use suction if the pneumothorax had not resolved after > 2 days, 15% always clamp the chest drain prior to removal; whereas 30% never do. NICE guidance recommends the use of digital suction but this has not translated into widespread usage: only 23% use digital suction to check for resolution of air leak). Conclusion: Whilst there has always been allowance for individual clinician preference in guidelines, there needs to be consensus on the optimum management strategy. The challenge the new guidelines face is to design a simple and pragmatic approach, using this new evidence base.
    Citation
    Hallifax, R. J. et al. (2022) ‘Pneumothorax management: current state of practice in the UK’, Respiratory Research, 23(1), pp. 1–4
    Publisher
    Respiratory Research
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15196
    Collections
    Respiratory Medicine

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