Consensus Statements
Management of Spontaneous Pneumothorax
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Chest Tube Removal
Key point: Chest tubes should be removed in a staged manner so as to ensure that the airleak into the pleural space has resolved. Management decisions for removing a chest tube are similar for PSP and SSP.
- Stage 1: Detect an airleak
A chest radiograph should demonstrate complete resolution of the pneumothorax and there should be no clinical evidence of an ongoing airleak, ie, continued bubbling in an airleak indicator before chest tube removal.
—Role of clamping of the chest tube before removal?
41% of panel respondents never clamp a chest tube to detect the presence of an airleak after re-expansion of the lung. The remaining panel members would clamp the chest tube 5 to 12 h after the last evidence of an airleak.
- Stage 2: Ensure no airleak
Whether tube clamped or not, repeat a chest radiograph 13 to 23 h after last evidence of airleak to ensure pneumothorax has not reoccurred.
Primary Data
Table 16—Chest Tube Removal Steps
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Other 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 when to provide recurrence prevention and what type of recurrence prevention to provide?
Recurrence Prevention Information
Would you like information regarding the role of computed tomography in the management of SSP?
Computed Tomography
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