Materiały źródłowe

• #1 Pneumothorax – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pneumothorax/diagnosis-treatment/drc-20350372

  The goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to re-expand. Depending on the cause of the pneumothorax, a second goal may be to prevent recurrences. The methods for achieving these goals depend on the severity of the lung collapse and sometimes on your overall health. […] Treatment options may include observation, needle aspiration, chest tube insertion, nonsurgical repair or surgery. You may receive supplemental oxygen therapy to speed air reabsorption and lung expansion. […] If only a small portion of your lung is collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the excess air is completely absorbed and your lung has re-expanded. This may take several weeks. […] If a larger area of your lung has collapsed, it’s likely that a needle or chest tube will be used to remove the excess air.

• #2 Approach of the treatment for pneumothorax

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4203983/

  Pneumothorax can occur in several situations such as; chronic obstructive pulmonary disease (COPD) where emphysema is observed or due to a biopsy for malignancy suspicion. In any case it is a dangerous situation that requires immediate attention and treatment. Pneumothorax can be divided in primary and secondary. Staging of pneumothorax is also very important. In our current editorial we summarize etiology and treatment of pneumothorax from a panel of pulmonary physicians, oncologists and thoracic surgeons. […] The treatment principles of pneumothorax include five principles: air elimination, reducing air leakage, healing the pleural fistula, promoting re-expand and preventing future recurrences, but treating underlying diseases, preventing and dealing complications are also important. The core of treatment is based on different etiology and pathogenesis. If patients did not get promptly and completely treatment that were combined with pneumothorax or underlying diseases, respiratory failure would be most dangerous. Therefore maintaining necessary respiratory function and stable hemodynamics are the first step of treatment.

• #3 Pneumothorax (Collapsed Lung): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15304-collapsed-lung-pneumothorax

  A pneumothorax can be a medical emergency. Go to the nearest emergency department right away if you think you could have collapsed lung. […] Your treatment depends on the cause, size and severity of your pneumothorax. Treatment may include: […] If your pneumothorax is minor, your provider may watch you for signs of heart or breathing problems. You’ll see your provider for a follow-up visit. […] If you have symptoms of a collapsed lung, go to the nearest emergency room. You may need immediate care. […] Some people need surgery to repair damage so a punctured lung can heal. You may need surgery if you don’t respond to other treatments or have: […] Many times, a pneumothorax can heal with minimal treatment. But any collapsed lung should be treated as a medical emergency until you know more. If you have signs or symptoms of a collapsed lung, such as chest pain or trouble breathing, get medical care right away. Your provider can determine the best form of treatment for you.

• #4 Spontaneous Pneumothorax Treatment Options

  https://aci.health.nsw.gov.au/networks/eci/clinical/tools/respiratory/spontaneous-pneumothorax/spontaneous-pneumothorax-treatment-options

  Suction should not be routinely employed as there is a risk of Re-expansion pulmonary oedema (RPO) due to the often delayed presentation. When used high volume low pressure suction systems are recommended. […] Rate of resolution of pneumothorax is between 1.25% and 2.2% every 24hrs. Thus a complete pneumothorax may take up to 6 weeks to resolve spontaneously.

• #5 Pneumothorax – Lung and Airway Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/lung-and-airway-disorders/pleural-and-mediastinal-disorders/pneumothorax

  Treatment is usually draining the air with a tube, sometimes a thin flexible tube (catheter) inserted into the chest. […] A small, primary spontaneous pneumothorax usually requires no treatment. It usually does not cause serious breathing problems, and the air is absorbed in several days. The full absorption of air in a larger pneumothorax may take 2 to 4 weeks. However, the air can be removed more quickly by inserting a catheter or chest tube into the pneumothorax. […] If a primary spontaneous pneumothorax is large enough to make breathing difficult, the air can be removed (aspirated) with a large syringe attached to a thin flexible tube (catheter) inserted into the chest. […] A chest tube may be used to drain the air if catheter aspiration is unsuccessful and when any other type of pneumothorax (such as a secondary spontaneous pneumothorax or a traumatic pneumothorax) occurs.

• #6 Spontaneous Pneumothorax Treatment Options

  https://aci.health.nsw.gov.au/networks/eci/clinical/tools/respiratory/spontaneous-pneumothorax/spontaneous-pneumothorax-treatment-options

  Observation is the treatment of choice for a small PSP without significant breathlessness. […] Needle/cannula aspiration (14-16G) is the treatment of choice in a haemodynamically stable patient with a large PSP or small PSP in a patient who is symptomatic. It has been shown to be as safe and effective as chest tube placement with the additional benefits of shorter length of stay and fewer hospital admissions. […] Following failed NA, small bore is recommended with admission. […] All SSP require admission. […] A large or symptomatic SSP requires small bore chest drain as first line treatment. […] If a small SSP then aspiration can be attempted first. […] If a patient is hospitalised for observation, supplemental high flow oxygen should be given. This treats possible hypoxaemia but has also been shown to result in a four-fold increase in rate of pneumothorax resolution.

• #7

  https://emorysurgicalfocus.com/2022/03/18/the-utility-of-oxygen-therapy-for-treating-pneumothorax/

  As with pleural effusions, patients with a large pneumothorax may be breathless and hypoxaemic and may require supplementary oxygen for symptom relief pending definitive treatment by aspiration or drainage. However, high concentration inhaled oxygen can also increase the rate of reabsorption of air from a pneumothorax up to fourfold. For this reason, the BTS guideline on the management of pneumothorax recommends the use of high concentration oxygen (reservoir mask) in all non-COPD patients who require hospital admission for observation due to a moderate-sized pneumothorax that does not require drainage. Once a pneumothorax is drained or aspirated successfully, the patient should not require oxygen therapy unless there is additional pathology such as pneumonia, asthma or COPD requiring specific treatment. […] In patients having hospital observation without drainage, the use of high concentration oxygen (15 l/min flow rate via reservoir mask) is recommended.

• #8 Acute Pneumothorax Evaluation and Treatment – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538316/

  Pneumothorax is classified into 3 main categories: spontaneous, traumatic, and tension pneumothorax. […] This activity reviews an in-depth review of the evaluation, diagnosis, and management of acute pneumothorax. The activity covers modern diagnostic tools, including radiology advancements, and outlines conservative and interventional treatment options. […] For symptomatic patients with stable vital signs, initial management may include needle aspiration or small-bore catheter insertion (pigtail catheter) in the emergency department. Evidence suggests that needle aspiration is as safe and effective as tube thoracostomy in cases of primary spontaneous pneumothorax. […] For secondary spontaneous pneumothorax, observation or needle aspiration is typically insufficient. These cases require hospital admission and chest tube insertion (ranging from 20 to 28 French), which is typically connected to a water-seal device with or without additional suctioning.

• #9 Approach of the treatment for pneumothorax

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4203983/

  Catheter drainage is the same with the aspiration which requires to be done in majority available positions. Moreover, easy-safe operation, less painful, effective drainage and fewer catheter blocked are requested. There are seemed conflicting. Effective drainage and fewer catheter blocked require a larger, harder and more holes catheter. On the other hand it is the reason of the difficulty of catheter placement and post-operative pain. Currently, disposable catheters with their supporting catheter needle are used commonly for example smaller-bore pigtail catheter which can be connected with Heimlich valve. […] In the recommendation of British Thoracic Society pneumothorax guideline 2010, needle (14~16 G) aspiration is as effective as large-bore (20 F) chest drains. But if failed, needle aspiration should not be repeated and small-bore (14 F) chest drains may be a good replacement. On the other side, small-bore chest drains should be the first choice, especially for the patients with pre-existing structuredness lung diseases.

• #10 Acute Pneumothorax Evaluation and Treatment – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538316/

  Patients with traumatic or tension pneumothorax require emergent thoracostomy or chest tube placement. […] Studies have shown that simple aspiration has a higher failure rate compared to chest tube drainage when used as the initial management strategy for complete primary spontaneous pneumothorax cases. […] Air drainage techniques are essential in managing pneumothorax. These techniques help remove air from the pleural space, facilitate lung reexpansion, and prevent recurrence. […] The management of pneumothorax in special populations requires specific considerations. […] For patients with primary spontaneous pneumothorax who have a high risk of recurrence, 2 surgical approaches have demonstrated comparable effectiveness: thoracic pleurodesis using pleural abrasion with minocycline pleurodesis and apical pleurectomy.

• #11 Pneumothorax – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pneumothorax/diagnosis-treatment/drc-20350372

  A hollow needle with a small flexible tube (catheter) is inserted between the ribs into the air-filled space that’s pressing on the collapsed lung. Then the doctor removes the needle, attaches a syringe to the catheter and pulls out the excess air. The catheter may be left in for a few hours to ensure the lung is re-expanded and the pneumothorax does not recur. […] A flexible chest tube is inserted into the air-filled space and may be attached to a one-way valve device that continuously removes air from the chest cavity until your lung is re-expanded and healed. […] If a chest tube doesn’t re-expand your lung, nonsurgical options to close the air leak may include: Using a substance to irritate the tissues around the lung so that they’ll stick together and seal any leaks. This can be done through the chest tube, but it may be done during surgery.

• #12 Diagnostics and Therapeutics: Managing Pneumothorax — Taming the SRU

  https://www.tamingthesru.com/blog/diagnostics/pneumothorax

  There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. […] This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. […] Chest tubes are available in a range of sizes, the smallest of which are pigtail, or 14 French (Fr), and the largest of which are large-bore catheters up to 40Fr in diameter. […] Pigtail catheters (8.5Fr – 14Fr) have similar efficacy to chest tubes and are associated with faster removal, fewer complications, and shorter hospital LOS. […] If pigtail is unsuccessful, tube thoracostomy should be performed. […] A 2010 systematic review of 3 RCTs found no difference in mortality, progression of PTX size, or length of hospital stay between chest tube and observation for stable trauma patients with occult PTX.

• #13 Pneumothorax Treatment & Management: Approach Considerations, Treatment Based on Risk Stratification, Options for Restoring Air-Free Pleural Space

  https://emedicine.medscape.com/article/424547-treatment

  Pleurodesis decreases the risk of recurrence, as does thoracotomy or VATS to excise the bullae. […] A tube inserted into the pleural space is connected to a device with one-way flow for air removal. […] The typical goal of inserting one-way valve systems is to avoid hospital admission and still treat the spontaneous pneumothorax. […] A Heimlich valve is a one-way rubber flutter valve that allows complete evacuation of air that is not under tension. […] First-time secondary SSP (including chronic obstructive pulmonary disease [COPD]) and traumatic pneumothorax typically require this approach. […] A small-bore catheter (eg, 7-14 French) is safe to use in most patients, whereas a larger chest tube (24 French) is also appropriate initially, and increasing suction pressure can be used if the lung fails to inflate.

• #14 Symptoms, Diagnosis and Treating Pneumothorax | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumothorax/symptoms-diagnosis-treatment

  The goal of treatment is to relieve the pressure on the lung and allow it to re-inflate. […] For a minor pneumothorax, your doctor may simply keep an eye on you, as the lung may re-inflate on its own, usually over the course of several weeks. In these cases, your doctor may suggest supplemental oxygen and require you to schedule follow-up visits to ensure that the problem does not worsen. […] For more serious pneumothorax, a needle aspiration or chest tube can be inserted into the chest cavity to remove the excess air. During a needle aspiration, a needle attached to a syringe is inserted between the ribs into the air-filled space that is pressing on the collapsed lung and is used to suction out the excess air. A chest tube involves a similar insertion that involves a one-way valve device that continuously removes air until the lung re-inflates. The tube may need to stay in for a few hours, or even a few days, to ensure that the lung does not collapse again.

• #15 Understanding Chest Tube Use for a Pneumothorax | RT

  https://respiratory-therapy.com/disorders-diseases/critical-care/acute-disorders/understanding-chest-tube-use-pneumothorax/

  The insertion point for a chest tube being used to relieve a pneumothorax is usually at the second or third intercostal space anteriorly on the midclavicular line or from the second or third down through the seventh intercostal space on the midaxillary line, with the tube directed toward the apex of the lung. […] Once the air has stopped leaking for 24 to 48 hours, indicating that the cause of the leak has been resolved, and a repeat chest radiograph shows the absence of free air, the chest tube is removed by simply pulling it out through the insertion site. […] One of the first steps in treating a sucking chest wound is to cover the hole in the chest at the end of expiration and hold the covering in place to stop the atmospheric air from moving into the chest. Then the hole should be closed with sutures, and the pneumothorax must be evacuated using a catheter, by needle aspiration, or through a chest tube.

• #16 Pneumothorax (Tension) – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/thoracic-trauma/pneumothorax-tension

  Tension pneumothorax should be diagnosed at the bedside based on clinical findings and treated immediately with needle decompression and/or tube thoracostomy. […] Treatment of tension pneumothorax is immediate needle decompression by inserting a large-bore (eg, 14- or 16-gauge) needle into the second intercostal space in the midclavicular line. The American College of Surgeons Advanced Trauma Life Support recommends placement in the fourth or fifth intercostal space along the midaxillary line, as it has been associated with improved success at decompression. Air will usually gush out. Because needle decompression causes a simple pneumothorax, tube thoracostomy should be done immediately thereafter.

• #17 How to identify and treat tension pneumothorax with needle decompression

  https://www.ems1.com/ems-products/medical-equipment/airway-management/articles/tension-pneumothorax-identification-and-treatment-Asl49JM7R1VxkXPt/

  Tension pneumothorax occurs when air is trapped in the pleural cavity. Treatment may include needle decompression. […] Treatment may include thoracic decompression, often called needle thoracostomy or needle decompression. […] For an open pneumothorax, treatment requires sealing the open wound with an occlusive dressing. […] If this does not relieve the trapped air, the next step is a thoracic decompression, often called needle thoracostomy or needle decompression. This involves using a needle catheter to release the trapped air in the pleural space. […] A needle decompression involves inserting a large bore needle in the second intercostal space, at the midclavicular line. This reduces intrathoracic pressure, allowing the lung to re-expand and restoring adequate ventilation and circulation.

• #18 Acute Pneumothorax Evaluation and Treatment – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538316/

  Pharmacotherapy for pneumothorax primarily focuses on pain control, both from the pneumothorax itself and procedures such as thoracostomy or needle aspiration. […] During chest tube insertion, prophylactic antibiotics should be considered to prevent insertion site infections and to reduce the risk of complications, such as empyema.

• #19 Pneumothorax Treatment & Management: Approach Considerations, Treatment Based on Risk Stratification, Options for Restoring Air-Free Pleural Space

  https://emedicine.medscape.com/article/424547-treatment

  Medication may be necessary to treat a pulmonary disorder that causes the pneumothorax. […] For example, intravenous (IV) antibiotics are included in the treatment of a pneumothorax that developed as a sequela of staphylococcal pneumonia. […] In addition, studies suggest that the administration of prophylactic antibiotics during chest tube insertion may reduce the incidence of complications such as emphysema. […] Clearly, the use of analgesics can provide patient comfort until the thoracostomy tube is removed. […] Some authors advocate the use of intercostal nerve blocks to increase patient comfort and decrease the need for narcotic analgesics. […] In patients with repeated pneumothoraces who are not good candidates for surgery, sclerotherapy with talc or doxycycline may be necessary.

• #20 Symptoms, Diagnosis and Treating Pneumothorax | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumothorax/symptoms-diagnosis-treatment

  In cases that involve an accident, or repeated collapsed lungs, the next step is a non-surgical repair of the leak. This can be done in several ways and is sometimes called pleurodesis. […] In the most extreme cases, surgery may be necessary to close the leak or remove the collapsed portion of the lung.

• #21 Pneumothorax Treatments and Surgery

  https://www.thebhdfoundation.org/what-is-bhd/symptoms-treatments/60-lung-collapse-treatments-and-surgery

  Chemical pleurodesis uses chemicals to irritate the lung. Most commonly talc (magnesium silicate) is used. […] In mechanical pleurodesis, a surgeon uses a piece of gauze to gently scratch the surface of the chest wall (the pleura). This causes it to stick to the chest wall and helps prevent further pneumothoraces. […] A pleurectomy is when a surgeon peals away the inner lining of the chest wall (the pleura), which allows the lung to stick to the chest wall and preventing further pneumothoraces. […] Lung resection is the surgical removal of part or all of a lung. […] Pleural covering is a relatively new surgical technique. It involves covering either all of the lung (total pleural covering, referred to as a TPC) or just the lower areas of the lung (lower pleural covering, referred to as an LPC) with a mesh. This mesh dissolves into the surface and strengthens the lung.

• #22 Pneumothorax Treatment & Management: Approach Considerations, Treatment Based on Risk Stratification, Options for Restoring Air-Free Pleural Space

  https://emedicine.medscape.com/article/424547-treatment

  If the patient has had repeated episodes of pneumothorax or if the lung remains unexpanded after 5 days with a chest tube in place, operative therapy may be necessary. […] The surgeon may use treatment options such as thoracoscopy, electrocautery, laser treatment, resection of blebs or pleura, or open thoracotomy. […] In patients with repeated pneumothoraces who are not good candidates for surgery, pleurodesis (or sclerotherapy) may be necessary. […] Pleurodesis decreases the chance of pneumothorax recurrence and should be performed in consultation with the surgeon.

• #23 Approach of the treatment for pneumothorax

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4203983/

  Persistent air leak must be controlled. The main treatment is to block the crevasse of visceral pleura by using titanium clips, endoscopic linear stapling device, biological glue or other adhesive materials. But apart from that, removing away or repairing the damaged parts are available. These operations are completed during surgery or thoracoscope. However, surgical indications are differed from country to country. Those patients who have undesired results, high recurrences, life-threatening and complex pathology mechanism are inclined to surgery. […] Another way to reduce air leakage is the endobronchial operation, the approach is relatively cumbersome but be appropriate for intractable pneumothorax. […] The basic method of healing crevasse is complete lung re-expansion which means making two layers of pleura fit together. And the methods are mentioned before. External force is available too, such as blocking the breach directly from the rupture of the visceral pleura as previously mentioned.

• #24

  https://link.springer.com/article/10.1007/s41030-025-00297-z

  The positioning of an indwelling pleural catheter (IPC) is a recently proposed approach for managing recurrent or persistent pneumothorax in patients unfit for surgery. […] Endobronchial treatments, including spigots and valves, have emerged as innovative approaches for managing pneumothorax, particularly in patients with persistent air leaks or those unfit for surgical intervention. […] Medical thoracoscopy, also known as pleuroscopy, can be used in the management of pneumothorax, offering a minimally invasive approach under local anaesthesia and preferably sedation to maximise the patients comfort. […] Surgical treatment is the cornerstone treatment modality in managing recurrent, persistent, or complicated cases of pneumothorax. […] The effective management of pneumothorax requires an approach tailored to the aetiology, severity, patient-specific factors and choices.

• #25 Pneumothorax – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pneumothorax/diagnosis-treatment/drc-20350372

  Sometimes surgery may be necessary to close the air leak. In most cases, the surgery can be performed through small incisions, using a tiny fiber-optic camera and narrow, long-handled surgical tools. The surgeon will look for the leaking area or ruptured air blister and close it off. […] You may need to avoid certain activities that put extra pressure on your lungs for a time after your pneumothorax heals. Examples include flying, scuba diving or playing a wind instrument. Talk to your doctor about the type and length of your activity restrictions. Keep follow-up appointments with your doctor to monitor your healing.

• #26 Treatment Options for Spontaneous Pneumothorax | Saint John’s Cancer Institute

  https://www.saintjohnscancer.org/thoracic/treatments/treatment-for-spontaneous-pneumothorax/

  Treatment for Spontaneous Pneumothorax […] Indications for an operation include the following: Air leak greater than 1 week, Recurrent pneumothorax on same side, Pneumothorax on the opposite side, Bilateral pneumothorax, Social or occupational reasons (pilot, diver, lives in an isolated area far from good health care), Certain medical illnesses (LAM, AIDS) […] The goals of an operation for a pneumothorax are to cut out the area on the lung where the air leaked to collapse the lung and to make the lung stick to the ribs so the lung cannot separate from the ribs. The operation can be performed through a big incision (thoracotomy) or minimally invasive surgery (small incisions). The success rate was 6 % for both VATS and thoracotomies. VATS operations are associated with less need for pain medicine and shorter length of stay in the hospital, VATS and talc pleurodesis have a 0-7% chance of recurrent pneumothorax.

• #27 Pneumothorax | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27370

  Indications for surgical intervention(VATS vs. thoracotomy) include continuous air leak for longer than seven days, bilateral pneumothoraces, the first episode in high-risk profession patients, i.e., Divers, pilots, recurrent ipsilateral pneumothorax, contralateral pneumothorax, and patients who have AIDS. […] Patients undergoing video-assisted thoracic surgery (VATS) get pleurodesis to occlude pleural space. Mechanical pleurodesis with bleb/bullectomy decreases the recurrence rate of pneumothorax to 5%. Options for mechanical pleurodesis include stripping the parietal pleura versus using an abrasive „scratchpad” or dry gauze. A chemical pleurodesis is an option for patients who may not tolerate mechanical pleurodesis. Options for chemical pleurodesis include talc, tetracycline, doxycycline, or minocycline, all irritants to the pleural lining.

• #28 Pneumothorax: from definition to diagnosis and treatment – Zarogoulidis – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/3117/html

  In view of a large PSP (50%), or in a PSP associated with breathlessness, guidelines recommend that reducing the size by aspiration is equally effective as the insertion of a chest tube. […] A chest tube (or intercostal drain) is the most definitive initial treatment of a pneumothorax. […] Chest tubes are required in PSPs that have not responded to needle aspiration, in large SSPs (50%), and in cases of tension pneumothorax. […] Pleurodesis is considered the final solution it is a procedure that permanently obliterates the pleural space and attaches the lung to the chest wall. […] A less invasive approach is thoracoscopy, usually in the form of a procedure called video-assisted thoracoscopic surgery (VATS). […] If pneumothorax occurs in a smoker, it may be advisable for someone to remain off work for up to a week after a spontaneous pneumothorax. […] In conclusion, treatment depends on the training of the pulmonary physician who handles such a patient, if the medical thoracoscopy can be applied then it could be the first option.

• #29 Recurrent Pneumothorax | Treatments at Neumark

  https://neumarksurgery.com/recurrent-pneumothorax/

  In some cases, chemical pleurodesis introducing an irritant into the pleural space to create adhesions can reduce the risk of future collapses. […] In recent years, the field of thoracic surgery has seen significant advancements in recurrent spontaneous pneumothorax treatment. Uniportal Video-Assisted Thoracoscopic Surgery (U-VATS) is one of the most groundbreaking developments. […] The precision and comprehensiveness of U-VATS make it particularly effective in reducing the risk of pneumothorax recurrence after surgery. […] While the risk of recurrence is significantly reduced after surgery, its not eliminated. […] As healthcare providers, we must address not just the physical aspects of the condition but also the emotional and psychological toll it can take. […] The key lies in a comprehensive approach: early recognition of symptoms, prompt treatment, effective prevention strategies, and, when necessary, state-of-the-art surgical interventions like U-VATS.

• #30 Pneumothorax

  https://www.svhlunghealth.com.au/conditions/pneumothorax

  Surgery there are several types of surgery for pneumothorax: […] Thoracoscopy (also known as video-assisted thoracoscopic surgery or VATS) is where a small camera is placed in the wall of your chest to help determine the best treatment; possibilities post-surgery include closing up blisters and air leaks, or removing a portion of the lung that has collapsed (called a lobectomy) […] Thoracotomy where an incision is made in the pleural space to help determine a suitable treatment option.

• #31 Pneumothorax – TeachMeSurgery

  https://teachmesurgery.com/cardiothoracic-surgery/pleural/pneumothorax/

  Following chest drain insertion, a CXR must be performed; any persisting pneumothorax or clinical instability warrants discussion with a thoracic surgeon. […] Further intervention is considered in those with a persistent air leak or failure of lung re-expansion. […] In spontaneous cases, medical pleurodesis is often trialled, which results in the partial obliteration of the pleural space through the introduction of an irritant agent, aiming to prevent recurrences. Alternatively, a Heimlich valve can be trialled, a one-way valve that is attached to a chest tube and enables complete evacuation of air that is not under tension. […] Those failing these interventions, or in traumatic cases, should be considered for surgical intervention. This includes either video-assisted thoracoscopic surgery (VATS) for pleurectomy +/- pleural abrasion, or open thoracotomy and pleurectomy.

• #32 Pneumothorax Treatment & Management: Approach Considerations, Treatment Based on Risk Stratification, Options for Restoring Air-Free Pleural Space

  https://emedicine.medscape.com/article/424547-treatment

  The decision to observe or to treat with an immediate intervention should be guided by a risk stratification that considers the patient’s presentation and the likelihood of spontaneous resolution and recurrence. […] If the PSP is smaller than 15% (or estimated as small) and the patient is symptomatic but hemodynamically stable, needle aspiration is the treatment of choice. […] If the PSP is smaller than 15% and if the patient is asymptomatic, many consider observation to be the treatment of choice. […] If the PSP is greater than 15% (or estimated as large) aspiration using a pigtail catheter left to low suction or water seal is recommended. […] Spontaneous pneumothorax is a life-threatening condition in patients with severe underlying lung disease; thus, tube thoracostomy is the procedure of choice in SSP.

• #33

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-respiratory/pneumothorax

  A simple pneumothorax will spontaneously resolve as the air is absorbed. Supplemental oxygen increases the rate of resorption. For small primary spontaneous pneumothoraces (pleural line 1-2cm from the chest wall) with minimal symptoms, treatment may consist of 100% oxygen applied for a brief period of observation (3-6 hours), a repeat x-ray to ensure the pneumothorax is not enlarging, and close outpatient follow-up. If the patient is symptomatic, treatment options include aspiration, insertion of a pigtail catheter, or insertion of a small-bore standard chest tube. […] A larger primary spontaneous pneumothorax (pleural line 2-3cm from the chest wall) or any secondary pneumothorax will usually require admission in addition to drainage via catheter or chest tube. Research has shown that patients with secondary spontaneous pneumothorax frequently fail conservative management such as observation or simple aspiration. Caution is advised before draining a secondary pneumothorax, to ensure it truly is a pneumothorax and not a large bleb. Patients with a recurrent pneumothoraces may require a more aggressive management plan such as thoracoscopy and pleurodesis.

• #34 Treatment of secondary spontaneous pneumothorax in adults – UpToDate

  https://www.uptodate.com/contents/treatment-of-secondary-spontaneous-pneumothorax-in-adults

  Treatment of secondary spontaneous pneumothorax in adults […] Most patients with SSP are treated with supplemental oxygen and removal of air from the pleural space, typically by chest tube thoracostomy. Patients also typically undergo a definitive procedure to prevent recurrence during the same hospitalization. […] Additionally, in SSP, prevention of recurrence is an important consideration for management.

• #35 Diagnostics and Therapeutics: Managing Pneumothorax — Taming the SRU

  https://www.tamingthesru.com/blog/diagnostics/pneumothorax

  Patients with O2 saturation 92% should be placed on supplemental O2. […] If they are stable and the patient is not significantly short of breath, it is reasonable to treat with supplemental O2 and observation alone. […] For stable patients, supplemental O2 and chest tube/catheter thoracostomy are generally preferred over conservative measures as the risk of aspiration failure, prolonged air leak, and progression to tension PTX are greater in those with underlying lung pathology. […] Thoracostomy is preferable to aspiration due to higher failure rates of the latter and a theorized higher rate of persistent air leakage. […] Large bore chest tubes were traditionally used in case of concomitant hemothorax for theoretically improved drainage and decreased clotting risk. […] However, recent studies support that pigtail catheters are just as good (if not better) at draining hemothorax and have lower rates of failure as well as reduced pain at the insertion site. […] Managed with emergent needle thoracostomy decompression or finger thoracostomy. […] In one study of blunt trauma patients found to have occult pneumothorax, 85% were managed conservatively and only 3.9% of those patients ultimately required chest tube placement.

• #36 Pneumothorax – TeachMeSurgery

  https://teachmesurgery.com/cardiothoracic-surgery/pleural/pneumothorax/

  Small secondary spontaneous pneumothorax will require admission for observation, with a low threshold for attempting needle decompression. Those that are large and symptomatic require a chest drain, via Seldinger technique, to be placed. […] Traumatic pneumothoraces will normally require a surgical chest drain insertion, placed in the Triangle of Safety, or otherwise admitting for observation if small and asymptomatic; importantly, there is no role in needle decompression in traumatic non-tensioning pneumothoraces. […] For traumatic tension pneumothoraces, either needle decompression or finger thoracostomy is required, prior to chest drain insertion. […] Initial management of suspected tension pneumothorax should be needle decompression with high-flow oxygen, then subsequent chest drain insertion.

• #37 How Do You Fix a Collapsed Lung(Pneumothorax) at Home

  https://drbelalbinasaf.com/blog/how-do-you-fix-a-collapsed-lung-at-home/

  Follow your doctors advice and take any prescribed pain medications, especially in the first few weeks after treatment. […] A collapsed lung increases the risk of future collapses, with up to 50% of people experiencing another collapse, usually within a few months. Be aware of any recurring symptoms and seek medical help immediately if they occur. […] Delaying medical intervention can lead to complications, including further lung damage, respiratory failure, and in some cases, death. Prompt treatment can prevent these outcomes and improve recovery chances.

• #38 Approach of the treatment for pneumothorax

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4203983/

  Smoking cessation, persistent respiratory function exercise, proper breathing exercise, and expectoration training, are also means of reducing pneumothorax recurrence, especially for patients with underlying structuredness lung disease. Recently, there have some surgeons who are attempting to reinforce visceral pleura. Strengthening of the endangered visceral pleura parts with absorbable polymers may prevent the development of new subpleural blisters or emphysema bullae responsible for the disease recurrence. […] The complications of pneumothorax include effusion, hemorrhage, empyema; respiratory failure, pneumomediastinum, arrhythmias and instable hemodynamics need to be handled accordingly. Treatment complications refer to major pain, subcutaneous emphysema, bleeding and infection, rare re-expansion pulmonary edema. Skilled and standardized treatment is the key to prevent and reduce the complications.

• #39 GGC Medicines – Management of Pneumothorax

  https://handbook.ggcmedicines.org.uk/guidelines/respiratory-system/management-of-pneumothorax/

  Pneumothorax is defined as air in the pleural space. […] The flow diagram above for primary and secondary pneumothoraces provides a systematic approach to treatment decisions. […] Aspiration can often be effective in primary spontaneous pneumothorax and should be considered prior to chest drain insertion. […] Further treatment options include chest drain suction, pleurodesis and thoracic surgery. If a pneumothorax fails to respond to treatment within 48 hours, prompt referral to a respiratory physician is essential so that these options may be considered. […] Persons with a recurrent pneumothorax should be referred for a respiratory opinion as pleurodesis and investigation for underlying lung disease is indicated. […] Patients should be advised that they should not fly until the pneumothorax has resolved radiologically and for 1 week afterwards. […] Strong emphasis should be placed on the relationship between the recurrence of pneumothorax and smoking in an effort to encourage patients to stop smoking.

• #40

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3682

  Treatment can depend on the cause and severity of the collapsed lung. Treatment can also depend on whether the problem has returned. […] In some cases, oxygen may be given (through a mask). It may heal with rest, but your doctor will need to check you. […] Your doctor may have drained the excess air from your chest with a needle or tube. Sometimes surgery is done to help keep the lung inflated. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems.

• #41 Pneumothorax | Korey Stringer Institute

  https://koreystringer.institute.uconn.edu/pneumothorax/

  Pneumothorax can be divided into spontaneous, traumatic, or iatrogenic (result of medical procedures). […] The classic presentation of a PTX is shortness of breath and sharp pain in the chest while breathing. […] First, activate emergency medical services (EMS). Treatment incudes assessing vital signs (blood pressure, pulse, and breathing rate), listening for quality of breaths, and removing air from the pleural space, re-expanding the underlying lung, and preventing recurrence. […] There are no specific guidelines for returning to sports after traumatic pneumothorax. General timelines are based on case reports and expert opinions and range from 2-10 weeks. Pain has been shown to be the most likely factor in determining return to play. Additionally, return to play should not be allowed before radiographic resolution of the PTX. A physician must clear the athlete before re-introducing activity, and return should include a gradual progression back into activity with appropriate medical monitoring.

• #42 Pneumothorax

  https://www.physio.co.uk/what-we-treat/respiratory/conditions/restrictive/pneumothorax.php

  Active cycle of breathing exercises and postural drainage exercises supervised by a specialist physiotherapist […] For more information on how physiotherapy can help treat a Pneumothorax, or to book yourself an assessment, please contact us via email at [email protected] or ring us on 0330 088 7800. […] Once the cause of the pneumothorax has been identified and addressed, with the trapped air reduced or removed altogether, then rehabilitative care can begin. At Physio.co.uk, our physiotherapists will ensure you specialised treatment for your Pneumothorax. Depending on the severity and duration of your condition, your treatment may involve: […] At Physio.co.uk you will experience a personalised treatment session. Each appointment will be aimed at returning to your everyday activities and what you enjoy.

• #43 Pneumothorax – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/504

  Pneumothorax occurs when air gains access to, and accumulates in, the pleural space. […] A tension pneumothorax is a medical emergency that requires immediate decompression. […] First-line treatment of pneumothoraces depends on the clinical scenario and patient preferences. It may include observation with supplemental oxygen therapy, the use of an ambulatory device (where available), percutaneous aspiration of the air in the pleural space, insertion of a chest drain, and in some patients video-assisted thoracoscopy (VATS) or thoracostomy. […] Pleurodesis (either by mechanical abrasion or by chemical irritation of pleural surfaces) can be used to limit the likelihood of recurrence, and multidisciplinary teams should be involved in decision-making.

• #44

  https://link.springer.com/article/10.1007/s41030-025-00297-z

  Pneumothorax, defined by the presence of air in the pleural cavity, is a potentially life-threatening condition requiring prompt diagnosis and tailored management. […] Management strategies for pneumothorax vary according to severity and aetiology. Conservative care, involving vigilant observation and supplemental oxygen, is suitable for small, stable pneumothoraxes. Needle aspiration can be an effective first-line treatment, although it may fail in some instances, necessitating escalation. […] Chest drainage remains a cornerstone therapy. Indwelling pleural catheters may be implemented in selective cases. […] Medical thoracoscopy with talc poudrage provides both diagnostic and therapeutic benefits in patients unsuitable for surgery, while surgical intervention represents the gold standard for definitive treatment.

• #45 Pneumothorax Therapy: Treatment and Expert Surgical Options

  https://marcoscarci.co.uk/knowledge-base/pneumothorax-therapy-options/

  Pneumothorax, commonly referred to as a collapsed lung, occurs when air leaks into the space between the lung and the chest wall. This condition can lead to reduced oxygen levels in the body, making appropriate Pneumothorax therapy vital. […] The treatment for pneumothorax varies according to its severity. In mild cases, patients may simply be monitored. The body often reabsorbs the air with time. However, for those experiencing significant symptoms or larger pneumothorax, more aggressive treatments are essential. Options can involve the insertion of a chest tube to remove the trapped air and re-inflate the lung. […] In some cases, surgery becomes imperative, particularly if the pneumothorax is recurrent or does not respond to other treatments. Surgical options include video-assisted thoracoscopic surgery (VATS) or open surgery, depending on the situation. These procedures not only help remove the air and any damaged lung tissue but also aim to prevent future occurrences by addressing underlying issues. […] Timely treatment, whether surgical or non-surgical, can significantly enhance recovery and lung health.

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