Results of simple aspiration of pneumothoraces

doi:10.1016/0007-0971(85)90028-2

British Journal of Diseases of the Chest

Volume 79, 1985, Pages 177-182

https://doi.org/10.1016/0007-0971(85)90028-2 Get rights and content

Abstract

The results of simple aspiration in 30 cases of pneumothorax are presented. The procedure was successful in 33% of cases with known pre-existing lung disease, and in 83% of those without.

Aspiration was also more successful in those patients under 50 years of age and if the estimated degree of lung collapse was less than 50%.

References (6)

W.Y. Inouye et al.
Spontaneous pneumothorax: treatment and mortality
Dis. Chest
(1967)
O.G. Raja et al.
Simple aspiration of spontaneous pneumothorax
Br. J. Dis. Chest
(1981)
A.A.D. Hamilton et al.
Treatment of pneumothorax by simple aspiration
Thorax
(1983)

There are more references available in the full text version of this article.

Cited by (50)

Study of the usefulness of small-bore aspiration catheters (Aspiration Kit<sup>®</sup>) for treating pneumothorax
2018, Respiratory Investigation
Citation Excerpt :
In the treatment of pneumothorax, small-bore aspiration catheters cause less pain than conventional trocar catheters in patients. However, only a few reports from overseas have compared small-bore aspiration catheters and drainage tubes with respect to the prognosis of pneumothorax and treatment duration [5,6], and there have been no reports of any similar studies in Japan. In the present study, no significant difference was noted in drainage treatment failure between the small-bore aspiration catheter-treated group and the trocar catheter-treated group.
Small-bore aspiration catheters (Aspiration Kit^®) cause less pain than conventional trocar catheters in patients. The objective of this study was to examine the usefulness of these less invasive small-bore aspiration catheters for drainage of pneumothorax.
Baseline characteristics and laboratory test data at admission of 70 patients who were admitted to and underwent drainage treatment for pneumothorax at our hospital between April 2011 and February 2017 were retrospectively reviewed based on their medical records. The primary endpoints were factors associated with drainage treatment failure, and baseline characteristics and laboratory test data were compared between those treated with a small-bore aspiration catheter and those treated with a trocar catheter.
The numbers of patients with anticoagulant use (P < 0.0001), ischemic stroke (P = 0.0063), and atrial fibrillation (P = 0.0410) were significantly different between the two groups. No significant intergroup differences were noted with respect to the length of hospitalization, drainage duration, subcutaneous emphysema, and treatment failure. Logistic regression analyses of baseline characteristics showed that the severity of pneumothorax, localization of pneumothorax, and recurrent pneumothorax were significantly associated with drainage treatment failure, but the type of drainage catheter was not significantly associated with treatment failure. [Conclusions] The results suggest that small-bore aspiration catheters, which cause less pain in patients, are potentially useful for pneumothorax drainage.
Presenting hydrothorax predicts failure of needle aspiration in primary spontaneous pneumothorax
2016, American Journal of Emergency Medicine
Citation Excerpt :
Large pneumothorax was one of the significant predicators of failure in this study. The result was in line with previous studies [15–19]. The BTS guidelines suggest to cease needle aspiration after 2.5 L of air has been aspirated [7].
The objective was to evaluate if existence of hydrothorax in initial chest radiograph predicts treatment outcome in patients with primary spontaneous pneumothorax who received needle thoracostomy.
This is a retrospective cohort study carried out from January 2011 to August 2014 in 1 public hospital in Hong Kong. All consecutive adult patients aged 18 years or above who attended the emergency department with the diagnosis of primary spontaneous pneumothorax with needle aspiration performed as primary treatment were included. Age, smoking status, size of pneumothorax, previous history of pneumothorax, aspirated gas volume and presence of hydropneumothorax in initial radiograph were included in the analysis. The outcome was success or failure of the needle aspiration. Logistic regression was used to identify the predicting factors of failure of needle aspiration.
There were a total of 127 patients included. Seventy-three patients (57.5%) were successfully treated with no recurrence upon discharge. Among 54 failure cases, 13 patients (10.2%) failed immediately after procedure as evident by chest radiograph and required second treatment. Forty-one patients (32.3%) failed upon subsequent chest radiographs. Multivariate logistic regression showed factors independently associated with the failure of needle aspiration, which included hydropneumothorax in the initial radiograph (odds ratio [OR] = 4.47 [1.56i12.83], P = .005), previous history of pneumothorax (OR = 3.92 [1.57-9.79], P = .003), and large size of pneumothorax defined as apex-to-cupola distance ≥ 5 cm (OR = 2.75 [1.21-6.26], P = .016).
Hydropneumothorax, previous history of pneumothorax, and large size were independent predictors of failure of needle aspiration in treatment of primary spontaneous pneumothorax.
Evidence-based management of paediatric primary spontaneous pneumothorax
2009, Paediatric Respiratory Reviews
The exact incidence of paediatric primary spontaneous pneumothorax (PSP) is unclear, although PSP incidence in the general population is between 6 and 18 per 100 000. PSP has been reported throughout the paediatric age range. A potential genetic predisposition for familial cases has been recently identified. Whilst there is universal consensus on the management of tension pneumothorax, lack of agreement and consistency exists across a wide range of management issues for other aspects of PSP management. Paediatric PSP may have a higher recurrence rate than adult PSP, and the presence of apical lung cysts or bullae is not predictive of recurrence. The decision for surgical intervention should be based on documented recurrence. There is a lack of paediatric evidence to guide management decisions, and extrapolation of predominantly adult data to younger age groups should not be encouraged. Given the relatively low apparent incidence, a multicentre approach to future research is required in order to generate the evidence required for informed management of PSP in children.
The Role of Simple Aspiration in the Management of Primary Spontaneous Pneumothorax
2008, Journal of Emergency Medicine
Citation Excerpt :
The studies of Markos et al. and Harvey and Prescott both found that outcome of simple aspiration is not influenced by initial size of pneumothorax (22,37). However, other studies (Archer et al., Soulsby, Mendis et al., and Ng et al.) have demonstrated that larger pneumothorax size is associated with failed aspiration (20,32,34,38). The inclusion of patients with secondary spontaneous pneumothorax in all these studies makes interpretation difficult.
According to an American College of Chest Physicians consensus statement published in 2001, it is recommended that chest tubes should be used for the drainage of primary spontaneous pneumothoraces. However, more recent expert opinions and guidelines suggest that simple aspiration is increasingly recognized as an acceptable alternative treatment. Studies have shown that the success rates and recurrence rates of simple aspiration are comparable to, if not more favorable than, those of chest tube drainage and small-bore catheter aspiration. Simple aspiration is the least invasive modality and it has economic cost-saving benefits, particularly with respect to admission rates and hospital length of stay. Its complication rate is low. However, a larger size of pneumothorax seems to be associated with increased likelihood of failure of simple aspiration. The author reviews the available evidence relating to the use of simple aspiration as a modality for treating primary spontaneous pneumothorax.
Pneumothorax and Barotrauma
2008, Critical Care Medicine: Principles of Diagnosis and Management in the Adult
Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010
2010, Thorax

View all citing articles on Scopus

View full text

General articleResults of simple aspiration of pneumothoraces

Abstract

Dis. Chest

Br. J. Dis. Chest

Treatment of pneumothorax by simple aspiration

Thorax

General article
Results of simple aspiration of pneumothoraces