Podcast 704: Treatment of Pneumothorax

<p><strong>Contributor: Adam Barkin, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Multi-center open-label non-inferiority trial looked at treatment of pneumothorax with a small-bore chest tube versus conservative management with exceptional follow up</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">316 patients ages 14-50 with moderate to large pneumothorax (>32% measured on CXR) were randomized into one of the two treatment arms</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">15% of the conservative group required further intervention as determined by prespecified protocols</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">94.4% of the intervention group had resolution at 8 weeks, whereas 98.5% of the conservative group had resolution at 8 weeks</span></li> <li style="list-style: none; display: inline;"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">These data were affected by poor follow up</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">CXR resolution average of 16 days in the intervention group and 30 days in the conservative group</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Symptom resolution was similar between the two groups (median 15 days vs. 14 days)</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Recurrence at 12 months was 17% in interventional group vs 8% in conservative group</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">41 adverse events in intervention group and 13 adverse events in conservative group</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Tre