Podcast 704: Treatment of Pneumothorax

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

316 patients ages 14-50 with moderate to large pneumothorax (>32% measured on CXR) were randomized into one of the two treatment arms

15% of the conservative group required further intervention as determined by prespecified protocols

94.4% of the intervention group had resolution at 8 weeks, whereas 98.5% of the conservative group had resolution at 8 weeks

These data were affected by poor follow up

CXR resolution average of 16 days in the intervention group and 30 days in the conservative group

Symptom resolution was similar between the two groups (median 15 days vs. 14 days)

Recurrence at 12 months was 17% in interventional group vs 8% in conservative group

41 adverse events in intervention group and 13 adverse events in conservative group