Simplified stepwise management of primary spontaneous pneumothorax: a pilot study

The European Respiratory Journal
C-H MarquettePneumothorax Study Group

Abstract

In primary spontaneous pneumothorax (PSP) requiring intervention, removal of air from the pleural space can be achieved by manual needle aspiration or by pleural drainage after insertion of a chest tube. This study aimed to evaluate the efficacy and safety of a serial-steps approach with a single system (small-calibre catheter/Heimlich valve) in a homogeneous population of patients with a first episode of PSP. All patients had an 8.5 F distally multiperforated polyurethane pigtail catheter inserted via the anterior route, at the bedside without any guidance, using the Seldinger technique. A one-way Heimlich valve was connected to the catheter, allowing the air to flow spontaneously outwards for 24-48 h. Thereafter, if the lung failed to re-expand wall suction was applied. Patients with an air leak persisting for >4 days were referred for surgery. Primary end-points were success rates at 24 h and 1 week, and 1 yr recurrence-free survival. In total, 41 consecutive patients entered the study. They were typically thin, young, smoking males. No procedure-related complications were observed. The need for pain relief medication was minimal. Within the first 24 h, most of the patients were able to walk around and half of them were able...Continue Reading

Citations

Jun 2, 2007·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M KloppH Hoffmann
Mar 14, 2007·Emergency Medicine Journal : EMJ·Demosthenes MakrisCharles-Hugo Marquette
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Aug 5, 2009·Paediatric Respiratory Reviews·Paul D RobinsonSarath C Ranganathan
May 20, 2006·La Presse médicale·Sylvie Leroy, Charles-Hugo Marquette
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Apr 14, 2017·The European Respiratory Journal·Jean-Marie Tschopp, Charles-Hugo Marquette
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May 29, 2021·Revue des maladies respiratoires·P ChauvinS Jouneau
Nov 27, 2020·Respiratory Medicine and Research·S JouneauJ Messika

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