Prognosis by Lung Collapse Rate of Spontaneous Pneumothorax Detected during Health Checkups

Abstract Background: Conservative observation with/without oxygen supplementation, aspiration, or tube drainage is selected as an initial treatment for spontaneous pneumothorax. In this study, we have examined the efficacy of initial management for cessation of air leak and prevention of recurrence separately, with consideration of the degree of lung collapse.Methods: Spontaneous pneumothorax in patients who underwent initial management in our institute between January 2006 and December 2015 were included in this retrospective, single-institutional study. Multivariate analyses were conducted to identify risk factors related to the persistent air leak after initial treatment and those related to ipsilateral recurrence after last treatment.Results: In the multivariate analysis for predicting persistent air leak after first treatment, repeated episode of ipsilateral pneumothorax (p = 0.0022), high degree of lung collapse (p = 0.032), and bulla formation (p < 0.0001) were the statistically significant risk factors for treatment failure. Recurrence of ipsilateral pneumothorax was observed in 126 cases. In the multivariate analysis for predicting the recurrence, repeated episode of ipsilateral pneumothorax was the significant risk factor (p = 0.0032).Conclusions: Predicting factors for persistent air leak after initial treatment were recurrence of ipsilateral pneumothorax, high degree of lung collapse, and radiological evidence of bullae. The predictive factor for recurrence after the last treatment was recurrence of ipsilateral pneumothorax. Selection of either observational or interventional approach at initial management did not affect the outcomes evaluated. Therefore, because of treatment invasiveness, observation is recommended to be attempted first in cases sans risk factors.Trial Registration: retrospectively registeredDate of IRB approval: May 28, 2018Number of IRB approval: 2017320

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P212 Should intercostal tube drainage be the first intervention in the management of primary spontaneous pneumothorax with complete lung collapse?: Abstract P212 Table 1 -

Thorax ◽

10.1136/thoraxjnl-2013-204457.364 ◽

2013 ◽

Vol 68 (Suppl 3) ◽

pp. A172.1-A172

Author(s):

MB Ganaie ◽

S Bikmalla ◽

MA Khalil ◽

MA Afridi ◽

M Haris ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Primary Spontaneous Pneumothorax ◽

Lung Collapse ◽

Tube Drainage

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Unilateral Pulmonary Oedema following Re-Expansion of Pneumothorax

Anaesthesia and Intensive Care ◽

10.1177/0310057x7500300104 ◽

1975 ◽

Vol 3 (1) ◽

pp. 19-30 ◽

Cited By ~ 19

Author(s):

M. X. Shanahan ◽

Ian Monk ◽

H. J. Richards

Keyword(s):

Pulmonary Oedema ◽

Spontaneous Pneumothorax ◽

Rare Complication ◽

Bronchial Obstruction ◽

Case Review ◽

Review Of The Literature ◽

Lung Collapse ◽

Capillary Membrane ◽

Major Factors ◽

Alveolar Capillary

Unilateral pulmonary oedema is a rare complication in the routine management of spontaneous pneumothorax. Previous reports have emphasized excessive negative intrapleural pressure, rapid re-expansion of the lung and bronchial obstruction as major factors in the pathogenesis. We have encountered four cases, and at least one of these factors have been absent in each case. Review of the literature, and our own experience suggests that the major factor is chronic and total lung collapse resulting in hypoxia and increased alveolar-capillary membrane permeability. Other factors which may be contributory are discussed.

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Seorang Perempuan Perokok Tembakau dan Mariyuana dengan Pneumotoraks Spontan Primer Akibat Blep Multipel yang Pecah

Jurnal Respirasi ◽

10.20473/jr.v1-i.2.2015.53-59 ◽

2019 ◽

Vol 1 (2) ◽

pp. 53

Author(s):

Yenny Kusmatuti ◽

Isnin Anang Marhana

Keyword(s):

Spontaneous Pneumothorax ◽

Bronchopleural Fistula ◽

Good Condition ◽

Primary Spontaneous Pneumothorax ◽

Lung Collapse ◽

Chest X Ray ◽

The Right ◽

Short Time ◽

Smoke Tobacco ◽

Smoking Marijuana

Background: Primary spontaneous pneumothorax (PSP) can be caused by a ruptured blep emfisematus subpleural. People who smoke tobacco and marijuana simultaneously arise PSP will be more risky than just smoking tobacco. Pneumothorax in cannabis smokers may occur due to coughing at the time was holding their breath, when they were smoking marijuana. Case: We report the case of 33-year-old woman with recurrent shortness of breath as a result of primary spontaneous pneumothorax in the right hemithorax. The patient’s tobacco and marijuana smokers. Patients had undergone previous pleurodesis. Chest X-ray picture of the lines conveniently indicates lung collapse and air-fluid level in the right hemithorax. Thoracoscopic showed a large bronchopleural fistula. During thoracotomy found one bronkopeural fistula, three large blep, and more than 15 small blep. Then do the suturing of fistula and blep. Patients recover in a short time and in good condition during treatment. Conclusion: Tobacco and marijuana smoking is a risk factor that is synergistic to the occurrence of primary spontaneous pneumothorax. These patients consume both are irregular but have resulted in multiple blep that can rupture and cause a pneumothorax.

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