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Consensus Statements

Management of Spontaneous Pneumothorax
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Table 12—Secondary Spontaneous Pneumothorax With Signs and Symptoms Present >2 days: Initial Management
Pneumothorax size Patient stability Preferred management Acceptable management
Small Stable
Large Stable 7. Chest tube (any size), admit (VG)
 
Pneumothorax size Patient stability Certain circumstance Acceptable rarely
Small Stable 2. Admit, observe* (G)†
7. Chest tube (any size), admit (G)
1. Observe, discharge (G)
3. Aspirate, remove catheter, observe, discharge (VG)
4. Aspirate, remove catheter, admit (G)
5. Aspirate, Heimlich, discharge (G)
Large Stable 6. Aspirate, Heimlich, watch overnight (G) 4. Aspirate, remove catheter, admit (G)
5. Aspirate, Heimlich, discharge (G)
 
Pneumothorax size Patient stability Inappropriate Indeterminate option
Small Stable 8. Thoracoscopy (VG) 6. Aspirate, Heimlich, watch overnight (G)
Large Stable 1. Observe, discharge (VG)
2. Admit, observe (VG)
3. Aspirate, remove catheter, observe, discharge (VG)
8. Thoracoscopy (G)
*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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