Consensus Statements
Management of Spontaneous Pneumothorax
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Definitions
- Primary spontaneous pneumothorax
- a pneumothorax occurring in a patient without antecedent trauma or iatrogenic cause who has no clinically apparent underlying lung abnormalities or underlying conditions known to promote pneumothorax (eg, COPD)
- Secondary spontaneous pneumothorax
- a pneumothorax occurring in a patient without antecedent traumatic or iatrogenic cause in whom there is clinically apparent underlying lung disease
- Note: The consensus statement was developed for patients with secondary spontaneous pneumothorax due to COPD. Many of the treatment recommendations, however, also apply to patients who have underlying conditions other than COPD.
- Clinical stability
- Stable patient: All of the following present: respiratory rate <24 /min, heart rate >60/min or <120/min, normal blood pressure, room air O2 saturation >90%, and patient can speak in whole sentences between breaths.
Unstable patient: Any patient not fulfilling the definition of stable.
- Pneumothorax size
- Determined by distance from the lung apex to the ipsilateral thoracic cupola at the parietal surface as determined by an upright standard radiograph
- Small pneumothorax: <3 cm apex-to-cupola distance
Large pneumothorax: >3 cm apex-to-cupola distance
Abbreviations
ACCP = American College of Chest Physicians;
COPD = chronic obstructive pulmonary disease;
PSP = primary spontaneous pneumothorax;
SSP = secondary spontaneous pneumothorax
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