Consensus Statements
Management of Spontaneous Pneumothorax
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Initial Chest Tube Management
Key point: Suction may be used if the lung fails to expand or used immediately.
For a clinically stable patient with a small SSP, a clinically stable patient with a large SSP, or a clinically unstable patient with any size SSP
- Attachment of the chest tube to a water seal device with (some consensus) or without (good consensus) suction is acceptable management in most cases. Patients treated with water seal alone should be managed with suction if the lung fails to re-expand (good consensus).
- A Heimlich valve (good consensus) may be used although the panel considered a water seal device to be a better option for most patients.
Note: As opposed to the management of patients with primary spontaneous pneumothorax, recurrence prevention is considered a prime consideration during the first secondary spontaneous pneumothorax episode. Hence, recurrence prevention considerations are the suggested next step in the management of patients with a secondary spontaneous pneumothorax. Persistent airleaks and chest tube removal issues should be addressed after addressing recurrence prevention issues.
Primary Data
Table 15—Initial Chest Tube Management: Role of Suction
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Other Information
Would you like information regarding when to provide recurrence prevention and what type of recurrence prevention to provide?
Recurrence Prevention Information
Does your patient develop a persistent airleak after drainage tube placement and would you like information regarding airleak management?
Airleak Management
Would you like information regarding chest tube removal?
Chest Tube Removal
Would you like information regarding the role of computed tomography in the management of SSP?
Computed Tomography
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