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Predicting outcomes in primary spontaneous pneumothorax using air leak measurements
  1. Rob J Hallifax1,2,
  2. Magda Laskawiec-Szkonter2,
  3. Najib M Rahman1,2,3
  4. on behalf of The RAMPP Trial collaborators
  1. 1 Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
  2. 2 Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
  3. 3 NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
  1. Correspondence to Dr Rob J Hallifax, Oxford Respiratory Trials Unit, University of Oxford, Oxford OX3 7LJ, UK; robert.hallifax{at}


The initial treatment regime for primary spontaneous pneumothorax (PSP) is generic and non-personalised, often involving a long hospital stay waiting for air leak to cease. This prospective study of 81 patients with PSP, who required drain insertion, captured daily digital air leak measurements and assessed failure of medical management against prespecified criteria. Patients with higher air leak at day 1 or 2 had significantly longer hospital stay. If air leak was ≥100 mL/min on day 1, the adjusted OR of treatment failure was 5.2 (95% CI 1.2 to 22.6, p=0.03), demonstrating that early digital air leak measurements could potentially predict future medical treatment failure.

Trial registration number ISRCTN79151659.

  • pleural disease
  • respiratory measurement

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  • Contributors All authors included on the paper fulfil the criteria of authorship. All authors contributed to study concept, design and review of the manuscript. RJH conducted the analysis generated the figures and drafted the manuscript. RJH is the guarantor.

  • Funding The RAMPP study is funded by a Research for Patient Benefit grant (PB-PG-0213-30098) from the National Institute for Health Research (NIHR). RJH was funded by a Medical Research Council (MRC) Clinical Research Training Fellowship (Ref MR/L017091/1). NMR is funded by the NIHR Oxford Biomedical Research Centre.

  • Competing interests None declared.

  • Patient consent Formal written consent was taken as part of RAMPP trial.

  • Ethics approval 15/SC/0240.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The RAMPP trial is ongoing. Data sharing statement will be available on trial completion.

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