Consensus StatementsManagement of Spontaneous Pneumothorax
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| Pneumothorax size | Patient stability | Preferred management | Acceptable management |
|---|---|---|---|
| Small | Stable | — | 2. Admit, observe* (G)† |
| Large | Stable | 7. Chest tube (any size), admit (VG) | — |
| Small | Unstable | 7. Chest tube (any size), admit (VG) | — |
| Large | Unstable | 7. Chest tube (any size), admit (VG) | — |
| Pneumothorax size | Patient stability | Inappropriate | Indeterminate option |
|---|---|---|---|
| Small | Stable | 8. Thoracoscopy (VG) | 6. Aspirate, Heimlich, watch overnight (SC) |
| Large | Stable | 1. Observe, discharge (P) 2. Admit, observe (VG) 3. Aspirate, remove catheter, observe, discharge (VG) 8. Thoracoscopy (G) |
— |
| Small | Unstable | 1. Observe, discharge (P) 2. Admit, observe (P) 3.–5. Aspiration options (VG–P) 8. Thoracoscopy (VG) |
6. Aspirate, Heimlich, watch overnight (SC) |
| Large | Unstable | 1.–6., 8. All remaining management options (G–P) | — |
| Pneumothorax size | Patient stability | Certain circumstance | Acceptable rarely |
|---|---|---|---|
| Small | Stable | 7. Chest tube (any size), admit (SC) | 1. Observe, discharge (VG) 3.–5. Aspiration options (G–VG) |
| Large | Stable | 6. Aspirate, Heimlich, watch overnight (G) | 4. Aspirate, remove catheter, admit (G) 5. Aspirate, Heimlich, discharge (VG) |
| Small | Unstable | — | — |
| Large | Unstable | — | — |
| *Numbers refer to the management options found in Table 7 containing a complete description of the option. †Levels of consensus (Table 4) appear in parenthesis after option: P = perfect, VG = very good, G = good, SC = some consensus, NC = no consensus |
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