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Chest tube insertion new england journal of medicine psp#

Initial management – conservative, aspiration, chest drain.

It may not be without complications including development of Adult Respiratory Distress Syndrome (ARDS) (~5%), persistent pneumothorax, haemothorax and recurrence (1-4%). Recurrence rates are significant and somewhere between 10-50%.įor recurrent or complicated disease, the typical treatment is Video Assisted Thoracic Surgery (VATS) which might include apicectomy of the lung (using an endo-stapler) and mechanical or chemical pleurodesis. Simple aspiration ± chest drain may also be indicated.

High-flow oxygen speeds up resolution about 4x faster and is most pronounced in patients with a large pneumothorax. Initial management will include oxygen and analgesia.

Chest tube insertion new england journal of medicine psp#

It is most unusual for a PSP to cause a tension pneumothorax, so the presentation is often mild and most have had symptoms for a few days. The commonest presentation is that of sudden onset pleuritic chest pain and dyspnoea at rest. The vast majority of cases are due to ruptured sub-pleural blebs which for some reason seems to occur far more frequently in tall, skinny boys. Within our paediatric population the incidence is probably about 3/100,000.

It is rare and typically affects male adolescents and young adults. asthma, COPD, cystic fibrosis, infection, lung carcinoma etc.). Primary spontaneous pneumothorax (PSP) occurs in those patients with no underlying lung pathology, whereas secondary spontaneous pneumothoraces occur in patients with pre-existing lung conditions (e.g. Background and Overview Figure 1: Bilateral pneumothorax – blue arrows show lung edge