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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Pleural suction is recommended in traumatic pneumothorax, collapsed lung, and in patients with severe dyspnoea. Long-term results with tetracycline pleurodesis. Pneumothorax in cystic fibrosis: Am J Med Sci.

Operative pleurodesis in spontaneous pneumothorax. The symptoms do not correlate closely with the size of the pneumothorax Thoracostomy tubes after acute chest injury: Incise the skin and subcutaneous tissue with a lancet as far as the upper margin of the rib.

Chemical Pleurodesis is an option for patients that refuse surgery or are considered poor surgical candidates. The British Thoracic Society Fitness to Dive Group39 recommends that underwater diving should be permanently avoided after a pneumothorax, unless the patient has had bilateral open surgical pleurectomy.

Different guidelines have been adopted by other international bodies Surgical experience in the management of spontaneous pneumothorax, The BTS recommends that any patient requiring admission be reviewed by a respiratory physician within 24 hours.

BTS guidelines for the management of spontaneous pneumothorax

Identification of the the 2nd intercostal space is achieved by locating the end of the 2nd rib mediall where it attaches at the manubriosternal angle. Pheumothorax aspiration of pneumothorax. A pneumothorax is a collection of gas in the pleural space that results in a variable amount of lung collapse on the affected side. The BTS guidelines recommend use of a cannula no greater than 16G in diameter for aspiration though evidence that larger cannulae are more likely to cause a persistent pleural leakis limited.


The symptoms are often more severe than those associated with a primary pneumothorax because lung function may already have been compromised by the underlying pathological process. If the pleural leak exerts a one-way valve effect then a tension pneumothorax can develop. J Accid Emerg Med.

Video-assisted thoracoscopic treatment of spontaneous pneumothorax: Effectiveness of bleomycin in comparison to tetracycline as pleural sclerosing agent in rabbits.

Occurs most frequently in men aged 20—40 years and in tall, thin persons. The main indication for performing additional views would be where a secondary pneumothorax is suspected as identification of even a small pneumothorax in this setting may significantly influence management.

The clinical findings can be normal in a small pneumothorax. Urgent treatment is essential. The management of spontaneous pneumothorax. The pain radiates to the ipsilateral shoulder.

Spontaneous Pneumothorax – RCEMLearning

Computed tomography used to exclude pneumothorax in bullous lung disease. Journal List Thorax v. Copyright and License information Disclaimer. Management of pneumothorax in adults with cystic fibrosis. Results from 82 patients. Guidelines for the management of spontaneous pneumothorax.


Guidelins aspiration is less likely to succeed for secondary pneumothoraces guiidelines and is only recommended in this setting if the patient has a small pneumothorax cm in size and minimal symptoms. The procedure is performed as follows: Eur J Respir Dis. Consider spontaneous pneumothorax as a cause for acute chest pain and dyspnoea in young smokers as well as in patients with chronic obstructive pulmonary disease.

Management of spontaneous pneumothorax: Clinical signs Suppressed or missing respiratory sounds, impaired chest mobility, and hollow echoing hypersonoric percussion sounds are often observed.

If an air leak continues despite the suction, the leak should be treated surgically, nowadays usually endoscopically. See our privacy policy for more information on what cookies are, how we use them and how to change your preferences. Small drains eg FG have been shown to be associated with fewer complications particularly subcutaneous emphysema without prolonging time to resolution Traumatic pneumothorax is often associated with haemothorax. Invasive treatment Tension pneumothorax is always an indication for immediate treatment.

Unlike symptoms, the examination findings in primary spontaneous pneumothoraces are affected by the size of the pneumothorax.

A place for aspiration in the treatment of spontaneous pneumothorax.