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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Management of traumatic occult pneumothorax
Kabir Yadav1, Mohammad Jalili, Shahriar Zehtabchi
1The George Washington University Medical Center, Department of Emergency Medicine, Washington, DC, USA. kyadav@mfa.gwu.edu
Resuscitation
|July 13, 2010
Summary
Observation is as safe and effective as tube thoracostomy for managing occult pneumothorax (OPTX) in trauma patients. This review found no significant differences in outcomes like progression, mortality, or complications between the two treatments.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Radiology
Background:
- Occult pneumothorax (OPTX) is a pneumothorax identified on CT scans but not plain radiography.
- Management of OPTX in trauma patients is controversial, with options including observation and tube thoracostomy (TT).
Purpose of the Study:
- To evaluate the safety and efficacy of observation versus tube thoracostomy for managing OPTX in emergency department trauma patients.
Main Methods:
- Systematic review of randomized trials identified through major medical databases.
- Included studies focused on adult or pediatric trauma victims with OPTX, comparing observation to TT.
- Excluded were patients on positive pressure ventilation or those hemodynamically unstable.
Main Results:
- Three randomized trials with 101 patients met quality standards.
- No significant differences were found between observation and TT regarding OPTX progression, pneumonia risk, or length of stay.
- Mortality risk and empyema rates also showed no significant differences.
Conclusions:
- Current evidence suggests observation is a safe and effective alternative to tube thoracostomy for managing occult pneumothorax.
- Further research may be warranted to solidify these findings in larger patient cohorts.
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