Patient-centered guidelines for managing spontaneous pneumothorax

The British Thoracic Society has released updated guidelines for managing spontaneous pneumothorax. The new guidelines emphasize a symptom-based approach and patient preferences. Instead of categorizing patients as primary or secondary pneumothorax, the focus is on high-risk characteristics and the size of the pneumothorax. Patients with underlying lung disease, over 50 and smoking, suspected hemothorax, bilateral pneumothorax, or hemodynamic compromise are considered high-risk. These patients may benefit from interventions if the pneumothorax is of sufficient size. The guidelines also introduce the option of using ambulatory devices for patients who prefer early symptom relief without admission. Needle aspiration is still recommended first, followed by intercostal drain only if necessary. Additionally, the guidelines mention considering primary surgical intervention for certain high-risk patient groups where recurrence rates are important. The guidelines promote appropriate follow-up and advise patients about the risks of flying and scuba diving after resolution of pneumothorax.