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Spontaneous pneumothorax guideline

  1. Spontaneous Pneumothorax Care Guideline Recommendations/ Considerations · Symptoms include shortness of breath, pleuritic chest pain · Consider pleurodesis if 1st pneumothorax with high risk activities (ie pilot, deep sea diving) · Post surgical air leak > 7 days, convert chest tube to heimlich valve and repeat CXR, if stable discharge hom
  2. Spontaneous Pneumothorax Care Guideline Recommendations / Considerations Signs and symptoms of pneumothorax: tachypnea, hypoxia, shortness of breath, chest pain/ discomfort CT scan not routinely indicated, but may be ordered based on family/ patient/surgeon preference VATs for other indications i.e.: Empyema - use Empyema Car
  3. Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010 Andrew MacDuff,1 Anthony Arnold,2 John Harvey,3 on behalf of the BTS Pleural Disease Guideline Group INTRODUCTION The term 'pneumothorax' was first coined by Itard and then Laennec in 1803 and 1819 respectively,
  4. The guideline pertains to adultpatients with primary spontaneous pneumothorax and patients withsecondary pneumothorax associated with COPD. Many of therecommendations will have relevance to secondary pneumothoracesaffecting patients with underlying lung disorders other than COPD
  5. primary spontaneous pneumothorax and patients with secondary pneumothorax associated with COPD. Many of the recommendations will have relevance to secondary pneumothoraces affecting patients with un-derlying lung disorders other than COPD. Materials and Methods The guideline development process used the Delphi method to create and quantify.
  6. Primary spontaneous pneumothorax is a common problem faced by doctors in medical practice. It is a significant global health problem affecting adolescent and young adults. This article will review the etiopathology, diagnosis and current management guidelines. It aims to improve clinical practice an

Introduction. Spontaneous pneumothorax was first described in 1819 by L aënnec [] and has been traditionally categorised as primary or secondary spontaneous pneumothorax (PSP and SSP, respectively).PSP is defined as a spontaneous pneumothorax occurring in patients without a prior known underlying lung disease [].It remains the subject of ongoing debate, despite important progress achieved in. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. DOI: 10.1136/thx.2010.136986. Thorax. 2010;65 Suppl 2:ii18-31. doi: 10.1136/thx.2010.136986. British Thoracic Society pleural disease guideline 2010. Good algorithm for management of spontaneous pneumothoraces (both primary and secondary) A pneumothorax is a collection of gas in the pleural space that results in a variable amount of lung collapse on the affected side. By definition, spontaneous pneumothoraces occur in the absence of any trauma (including iatrogenic causes) to the chest wall. Primary spontaneous pneumothoraces occur in people with no underlying lung pathology Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010 Thorax. 2010 Aug;65 Suppl 2:ii18-31. doi: 10.1136/thx.2010.136986. Authors Andrew MacDuff.

Management of Spontaneous Pneumothorax - CHES

  1. In 2010, the British Thoracic Society (BTS) published their updated guidelines for the management of spontaneous pneumothorax. Here, the spontaneous pneumothorax was divided into 2 categories: Primary pneumothorax: No evidence of overt lung disease; air escapes from the lung into the pleural space through rupture of a small pleural bleb or the.
  2. This is the fourth update of the guidelines for the diagnosis and treatment of pneumothorax published by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Spontaneous pneumothorax, or the presence of air in the pleural space not caused by injury or medical intervention, is a significant clinical problem
  3. Management guidelines for spontaneous pneumothorax vary widely and are based mainly on expert opinion. Guidelines exclude patients that are physiologically unstable with any of the following abnormal vital signs or those with a secondary pneumothorax, as these patients generally require a chest-tube and admission
  4. The incidence of spontaneous pneumothorax is 7.4 to 18 cases per 100,000 population in men per year. In women, the reported incidence is 1.2 to six cases per 100,000 population per year. The.
  5. Background. Primary spontaneous pneumothorax (PSP) is a pneumothorax occurring in patients without underlying lung disease and in the absence of provoking factors such as trauma, surgery or mechanical ventilation. Secondary pneumothoraces may be harder to manage and have greater consequences
  6. The guideline was designed to be relevant to physicians who make management decisions for the care of patients with pneumothorax. Decisions for observation, chest tube placement, surgical.
  7. Thoracic endometriosis constitutes an uncommon cause of spontaneous pneumothorax in nonsmoking women of childbearing age. Symptoms are often non-specific and the diagnosis is often delayed. A thorough menstrual history and its temporal relationship to pneumothorax onset should be assessed in every women presenting with recurrent pneumothorax

Management of Spontaneous Pneumothora

ปฐม (Primary spontaneous pneumothorax) 7 เ⁄าเยบ'บกม=ไŽบ—ห- ^วนกม=บ 13-22 มวน¢อ'นและกม=บมากกา 22 มวนอน เ¡มความเ£ยงนเuน 21 เาและ 102 เ This guideline is intended for patients ages 12-21 years old with first episode of primary spontaneous pneumothorax. If underlying lung disease is suspected, or if there is concern for second or recurrent episode of spontaneous pneumothorax, the pulmonary service should be consulted, and other treatment regimens should be considered. N The management of spontaneous pneumothorax. BTS guidelines for the management of spontaneous pneumothorax. The Pheumothorax recommends that any patient requiring spontaneoue be reviewed by a respiratory physician within 24 hours. The British Thoracic Society Fitness to Dive Group39 recommends that underwater diving should be permanently avoided.

Management of primary spontaneous pneumothorax: a revie

Spontaneous pneumothorax management. Pallin M (1), Open M, Moloney E, Lane SJ. Author information: (1)AMNCH, Tallaght, Dublin 24. pallinm@gmail.com. Guidelines for the management of spontaneous pneumothorax were published by the British Thoracic Society (BTS) in 2003. The aim of our study was to assess compliance with the BTS guidelines Management guidelines for spontaneous pneumothorax vary widely and are based mainly on expert opinion Guidelines exclude patients that are physiologically unstable with any of the following abnormal vital signs or those with a secondary pneumothorax, as these patients generally require a chest-tube and admission: 1. SBP < 90 mmHg 2 Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010. Thorax. 2010; 65 : 18-31 View in Articl MacDuff A, Arnold A, Harvey J Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010 Thorax 2010;65:ii18-ii31. If patients were discharged no flying for a week after resolution and no diving are standard recommendations Guideline: Spontaneous Pneumothorax: Primary Management -CHW This document reflects what is currently regarded as safe practice. However, as in any clinical situation, there may be factors which cannot be covered by a single set of guidelines. This document does not replace the need for th

ERS task force statement: diagnosis and treatment of

Major differences exist between guidelines relating to the management of primary and secondary pneumothorax, some of which are outlined below.3 4 One key difference between guidelines is the method of measuring pneumothorax: the British Thoracic Society defines a pneumothorax as large with a >2 cm measurement from the lung margin to chest wall. Spontaneous pneumothorax means collection . or trapping of air between the chest wall and the lung spontaneously, causing collapse of the lung. In most cases trapped air should dissolve on . its own and not cause any problems. However, if this air expands then it can cause Guidelines for the management of spontaneous pneumothorax. Role of small calibre chest tube drainage for iatrogenic pneumothorax. Having said this, with the increasing use of ultrasound in Emergency Medicine, in the hands of an experienced user it can now reliably tje pneumothorax better than an anteroposterior chest radiograph Primary spontaneous pneumothorax is CD. A waiver can be considered based upon the guidelines below. A subsequent occurrence of spontaneous pneumothorax is CD. No waiver will be recommended unless surgical or chemical pleurodesis has been performed

Guidelines on spontaneous pneumothorax are contradictory as to intervention between needle aspiration (NA) and chest tube drainage (CTD). Studies show poor adherence to guidelines. Three Norwegian. Spontaneous Pneumothorax. In the British Thoracic Society14, proposed a method for quantifying pneumothorax size on a PA radiograph by measuring the distance guidellnes the lung edge to the thoracic wall at the level of the hilum:. When following the BTS guidelines, pneumothorax size should be determined on a PA chest radiograph by measuring. Conclusion The practice of clamping the chest drain before removal in spontaneous pneumothorax appear safe. Clamping saved chest drain reinsertion in 11.8% of cases, and has the potential to save.

A primary spontaneous pneumothorax occurs in young people without known respiratory illnesses. A secondary spontaneous pneumothorax occurs in patients with pre-existing pulmonary diseases. A tension pneumothorax is a medical emergency that requires immediate decompression. Patients with a pneumothorax typically report dyspnoea and chest pain Spontaneous pneumothorax in men in the United states is 7.4 per 100,000 population per year, and in 1.2 women per 100,000 population. Recurrent primary spontaneous pneumothorax range from 25 percent to more than 50 percent, with most recurrences occurring within the first year

2. Evaluation of spontaneous pneumothorax. The guidelines published by the American College of Chest Physicians (ACCP) define a small pneumothorax as a decrease in apical length of less than 3 cm5.However, the British Thoracic Society (BTS) designates a marginal depth measured from the chest wall to the outer pulmonary edge of less than 2 cm as a small pneumothorax, while a marginal depth of. Primary spontaneous pneumothorax (PSP) commonly occurs in young, thin, tall males. The diagnosis and management of PSP can vary from institution to institution as well as by characteristics of the pneumothorax. Diagnostic work-up can include physical exam, chest X-ray, and/or chest CT scan Ambulatory management of primary spontaneous pneumothorax significantly reduced the duration of hospitalisation including re-admissions in the first 30 days, but at the expense of increased adverse events. This data suggests that primary spontaneous pneumothorax can be managed for outpatients, using ambulatory devices in those who require intervention Algorithm for the management of a Spontaneous Pneumothorax (From BTS Guidelines 2010) done 4 Primary Pneumothorax: If discharged from ED/MAU, referral to chest clinic to be seen in 2 weeks Discharge advice : • return to ED immediately if more breathless or chest pain • avoid diving • avoid air travel until further advice in chest clini Brighton and Sussex University Hospitals and Western Sussex Hospitals have joined up to form a new NHS Foundation Trust for our area: University Hospitals Sussex

Spontaneous Pneumothorax British Association of

  1. Indeed, most reviews and guidelines about management of spontaneous pneumothorax do not recommend HRCT imaging at first episode . However, one study ( 12 ) did suggest that screening HRCT is cost-effective in younger, nonsmoking women after a first pneumothorax, with the expectation that some will be found to have LAM
  2. ation. 1 There has been a recent shift in the accepted management of PSP from intervention based purely on.
  3. Studies about primary spontaneous pneumothorax (PSP) in pediatric patients are not as many as in adult patients since the incidence of PSP is lower in children than in adults. There are evidence-based guidelines for the management of PSP in adults, whereas, in children, the approach of PSP is mainly extrapolated from the adult guideline
  4. T here are always times when our attempts to educate individual patients on evidence-based medicine fall short. This leads to a range of acceptable practice variation, with each clinician making their best judgment regarding the care of a patient. This variation is on impressive display with respect to the management of primary spontaneous pneumothorax (PSP)
  5. Figure 2 Recommended algorithm for the treatment of secondary pneumothorax. BTS guidelines for the management of spontaneous pneumothorax ii41 www.thoraxjnl.com Downloaded from thorax.bmj.com on 17 August 2008

Trial Design and Oversight. The Primary Spontaneous Pneumothorax (PSP) trial was a multicenter, prospective, randomized, open-label, noninferiority trial that was conducted at 39 metropolitan and. Objectives Paediatric guidelines are lacking for management of spontaneous pneumothorax. Adult patient-focused guidelines (British Thoracic Society 2003 and 2010) introduced aspiration as first-line intervention for primary spontaneous pneumothorax (PSP) and small secondary spontaneous pneumothoraces (SSP). Paediatric practice is unclear, and evidence for aspiration success rates is urgently. Primary spontaneous pneumothorax (PSP) is a condition that affects young, otherwise healthy people. A recent large epidemiological study reports an annual incidence of 22.7 per 100,000 and a sex ratio of 1:3.3 (women: men) [].Guidelines for the management of PSP include those produced by the British Thoracic Society (BTS) [] and the American College of Chest Physicians (ACCP) [] Persistent air-leak in spontaneous pneumothorax-clinical course and outcome. The impact of spontaneous pneumothorax, and its treatment, on the smoking behaviour of young adult smokers. BTS guidelines for the management of spontaneous pneumothorax. Deficiencies of management of spontaneous pneumothoraces The guideline was designed tobe relevant to physicians who make management decisions for the care ofpatients with pneumothorax. Options Decisionsfor observation, chest tube placement, surgical interventions, andradiographic imaging

See also. Primary spontaneous pneumothorax Acute pain management Trauma . Key points. Tension pneumothorax is a clinical diagnosis and requires immediate intervention; Patients undergoing thoracocentesis should receive analgesia both pre- and post-procedure Depending on the cause of the pneumothorax, a second goal may be to prevent recurrences. The methods for achieving these goals depend on the severity of the lung collapse and sometimes on your overall health. Treatment options may include observation, needle aspiration, chest tube insertion, nonsurgical repair or surgery. You may receive.

moderate pneumothorax (visible rim 1-2 cm between the lung margin and the chest wall) 1st line - percutaneous aspiration ± high-flow oxygen Aspirate <2.5 L using a 16-18G cannula. [12 Primary spontaneous pneumothorax is an abnormal accumulation of air in the space between the lungs and the chest cavity (called the pleural space) that can result in the partial or complete collapse of a lung. Explore symptoms, inheritance, genetics of this condition BACKGROUND: The key guidelines in the management of primary spontaneous pneumothorax (PSP) include the 2010 British Thoracic Society (BTS) Pleural Disease guideline and 2001 American College of Chest Physicians (ACCP) Consensus Statement. Current recommendations are dependent on radiographic measures which differ between these two guidelines. The aim of this study is to compare size. Spontaneous pneumothorax due to thoracic endometriosis syndrome is initially treated by managing the symptomatic presentation with stabilization of the patient (i.e., chest tube for pneumothorax) followed by secondary prevention of recurrence (e.g., blebectomy, pleurodesis, and hormonal therapy) 10. As mentioned, VATS is the gold standard for.

Spontaneous Pneumothorax - RCEMLearnin

  1. However, patients with a first episode of spontaneous pneumothorax who have a prolonged air leak (greater than 72 hours), incomplete expansion of the lung (Figure 1), bilateral pneumothoraces, associated hemothorax, tension pneumothorax (Figure 2), or a bleb on their CT scan (Figure 3) should be offered surgery at the time of the first.
  2. small stable pneumothorax were allowed to fly without recorded complication. This data led ANMC to establish the following clinical guidelines: A. Obtain a chest radiograph at least 4 hours after chest tube removal; if this shows no pneumothorax or a stable, unchanged small pneumothorax, the patient can be discharged locall
  3. The spontaneous pneumothorax was defined as PSP if the patient had no pulmonary disease and as SSP if the patient had a pulmonary disease or was ≥50 years old with a significant smoking history, according to the current BTS guideline . Significant smoking history in this case was defined as ≥10 pack-years
  4. imally symptomatic patients. 8,19 The ideal candidate for such an approach would be a patient with no previously identified underlying lung disorder who develops a small spontaneous pneumothorax that causes

Overview: Spontaneous pneumothorax is best defined as air in the pleural space of non-traumatic cause. Secondary spontaneous pneumothorax is one that occurs in the presence of underlying parenchymal or airway disease, and for aviation purposes will not be considered further. Primary spontaneous pneumothorax, by default, is one that occurs in the absence of such underlying disease Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010 By Phạm Thanh Minh Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term result Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Having said this, with the increasing use of ultrasound in Emergency Medicine, in the hands of an experienced user it can now reliably detect pneumothorax better than an anteroposterior chest radiograph Pneumothorax, sometimes abbreviated to PTX, (plural: pneumothoraces) refers to the presence of gas (often air) in the pleural space.When this collection of gas is constantly enlarging with resulting compression of mediastinal structures, it can be life-threatening and is known as a tension pneumothorax (if no tension is present it is a simple pneumothorax) Spontaneous pneumothorax is an abnormal condition of the lung characterized by the collection of gas in the pleural space between the lungs and the chest wall. This condition occurs without an obvious etiology and can be classified as either primary or secondary. Patients may present with symptoms such as tachycardia and dyspnea

What are the treatment guidelines for pneumothorax

Primary spontaneous. Spontaneous pneumothoraces are divided into two types: primary, which occurs in the absence of known lung disease, and secondary, which occurs in someone with underlying lung disease. The cause of primary spontaneous pneumothorax is unknown, but established risk factors include being of the male sex, smoking, and a family history of pneumothorax BTS guidelines for the management of spontaneous pneumothorax. Having said this, with the increasing use of ultrasound in Emergency Medicine, in the hands of an experienced user it can now reliably detect pneumothorax better than an anteroposterior chest radiograph. Intrapleural tetracycline for spontaneous pneumothorax with persistent air leak Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010 Aug. 65 Suppl 2:ii18-31. . . Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement Estimating Pneumothorax Size. Measuring pneumothoraxes. Line A = lung apex to cupola. Line B = interpleural distance. On a conventional, upright posterior-anterior chest radiograph: Very small: <1 cm interpleural distance (confined to upper 1/3 of chest) OR only seen on CT. Small: ≤3cm lung apex to cupola (chest wall apex) on CXR

Guidelines for the Diagnosis and Treatment of Spontaneous

The ERS-education website provides centralised access to all educational material produced by the European Respiratory Society. It is the world's largest CME collection for lung diseases and treatment offering high quality e-learning and teaching resources for respiratory specialists. This distance learning portal contains up-to-date study material for the state-of-the-art in Pulmonology This is the fourth update of the guidelines for the diagnosis and treatment of pneumothorax published by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Spontaneous pneumothorax, or the presence of air in the pleural space not caused by injury or medical intervention, is a significant clinical problem. We propose a method fo Primary Spontaneous Pneumothorax (PSP) Evidence-Based Guideline Definition: Pneumothorax refers to air in the pleural cavity (i.e., interspersed between the lung and the chest wall). (1,2) Primary spontaneous pneumothorax (PSP) occurs in otherwise healthy patients; secondary pneumothorax is associated with underlying lung disease. (1-4

Pleurodesis without is an option to prevent recurrence of a pneumothorax. A large study in The VA system showed a 25% recurrence rate for tetracycline versus no pleurodesis. Therefore, surgical treatment is better than pleurodesis through a chest tube. Non-surgical treatment can be used for patients who are not good candidate for an operation #### Summary points Pneumothorax describes the presence of gas within the pleural space, between the lung and the chest wall. It remains a globally important health problem, with considerable associated morbidity and healthcare costs. Without prompt management pneumothorax can, occasionally, be fatal. Current research may in the future lead to more patients receiving ambulatory outpatient. The approach to the initial management of spontaneous pneumothorax differs markedly from centre to centre, and it is difficult in practice to establish a standard protocol. This article reviews the concepts behind the British Thoracic Society guidelines, and reports the varying opinions and alternative practices existing currently. There is a need for more evidence-based studies to identify.

Management of Spontaneous Pneumothorax Emergency

A spontaneous pneumothorax is a collapsed lung. Part or all of the lung may collapse. Air collects in the pleural space (the space between the lungs and chest wall). The trapped air prevents your lung from filling, and the lung collapses. A spontaneous pneumothorax can happen in one or both lungs. A primary spontaneous pneumothorax occurs in a. Primary spontaneous pneumothoraces (PSP) remain a significant global problem, occurring in healthy subjects with a reported incidence of 18-28/100 000 per year for men and 1.2-6/100 000 per year for women. 1, 2 Many patients do not seek medical advice for several days, with 46% waiting more than 2 days despite symptoms. 3 There are four published guidelines for the management of PSP

Recommended treatment algorithm for a primary spontaneous pneumothorax* *based upon BTS guidelines 2003 Primary Spontaneous Pneumothorax Pneumothorax >2cm Intercostal drain & admit Breathless? Aspirate ?successful Observe for 2 hours and discharge if stable All patients admitted should be given high flow oxyge Abstract: Spontaneous pneumothorax can be divided into two categories: primary and secondary. The management of each one depends on resource availability, physician preference, and procedural capability, and is broadly based on guidelines that are over a decade old Spontaneous pneumothorax is an inherited disease which leaves some people with weakened areas of the pleural lining of the lung, called blebs or blisters.These can occasionally burst and cause air to leak from the lung to the chest cavity, resulting in a pneumothorax ('air in the chest') BTS guidelines for the management of spontaneous pneumothorax. The guidance below is based upon the BTS guidelines Chest radiograph-a poor method for determining the size of a pneumothorax. Patients with spontaneous secondary pneumothoraces less than 1cm in size and minimal symptoms do not require drainage in the ED but should be admitted for.

Diagnosis and Management of Spontaneous Pneumothora

The management of primary spontaneous pneumothorax (PSP) is currently being debated. The British Thoracic Society (BTS) guidelines [1] are over a decade old and recent European Respiratory Society (ERS) guidance [2] summarises more up-to-date evidence. Needle aspiration, intercostal drain insertion (ICD) and observation are all advocated International guidelines do not recommend surgery for the first episode of primary spontaneous pneumothorax (PSP), except in cases of persistent air leak, hemopneumothorax, bilateral pneumothorax.

Pneumothorax (Spontaneous) A pneumothorax (air leak) is an abnormal collection of air in the space between the lung and chest wall. It can occur in children with no other lung problems because of a small area of weakness in the lung. This area can open, allowing air into the space outside the lung. This air pushes on the lung and can collapse it Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. MacDuff A , Arnold A , Harvey J , BTS Pleural Disease Guideline Group Thorax , 65 Suppl 2:ii18-31, 01 Aug 201 Background: The key guidelines in the management of primary spontaneous pneumothorax (PSP) include the 2010 British Thoracic Society (BTS) Pleural Disease guideline and 2001 American College of Chest Physicians (ACCP) Consensus Statement. Current recommendations are dependent on radiographic measures which differ between these two guidelines Primary spontaneous pneumothorax (PSP) is an uncommon presentation in children but may occur at any age and occurs in patients with no pre-existing lung disease. Management aims are to re-expand the collapsed lung, relieve pressure in the intrapleural space and avoid a tension pneumothorax. Correct management of PSP will avoid unnecessary intervention, reduce length of hospital stay and also.

Pneumothorax - Treatment algorithm | BMJ Best Practice

Clinical Practice Guidelines : Primary spontaneous

The guideline was designed to be relevant to physicians who make management decisions for the care of patients with pneumothorax. Options: Decisions for observation, chest tube placement, surgical interventions, and radiographic imaging Primary spontaneous pneumothorax (PSP) is managed in accordance with the adult British Thoracic Society (BTS) guidelines due to lack of paediatric evidence and consensus. We aim to highlight the differences and provide a best practice surgical management strategy for PSP based on experience of two major paediatric surgical centres Primary spontaneous pneumothorax (PSP) is a relatively common disease and occurs in individuals without underlying lung disease. There are some guidelines for conventional management of PSP [1,2,3], mainly divided into conservative and surgical treatments.Conservative treatments including observation, simple aspiration, or chest tube drainage are associated with a relatively high recurrence. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 65 (Supple 2), ii18-31 (2010). PubMed Google Schola

PPT - Management of spontaneous pneumothorax : BritishManagement of large primary spontaneous pneumothorax inRecurrence rates in primary spontaneous pneumothorax: a

Primary Spontaneous Pneumothorax: File Size: 349 kb: Download File. Secondary Spontaneous Pneumothorax: File Size: 145 k Primary spontaneous pneumothorax often affects young males, tall and thin built, often smokers. The incidence of recurrence is 20 to 60% in the first 3 years after the first episode. Secondary spontaneous pneumothoraces also occur in patients with underlying lung disease; thus epidemiology varies greatly We read with great interest the article by Noh et al. [1], analyzing the recurrence of primary spontaneous pneumothorax (PNX) and the efficacy of video-assisted thoracic surgery (VATS) in the treatment of young adults and children. The Authors' data showed a higher recurrence rate of PNX after surgery in patients aged <=16 years than in older ones Tension pneumothorax. Put out an immediate cardiac arrest call for any patient with suspected tension pneumothorax and give high-flow oxygen.Immediate decompression is required; do not wait for confirmation of the tension pneumothorax on imaging. MacDuff A, Arnold A, Harvey J; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease.

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