Walker, SP;
Keenan, E;
Bintcliffe, O;
Stanton, AE;
Roberts, M;
Pepperell, J;
Fairbairn, I;
... Maskell, NA; + view all
(2021)
Ambulatory management of secondary spontaneous pneumothorax: a randomised controlled trial.
European Respiratory Journal
, 57
(6)
, Article 2003375. 10.1183/13993003.03375-2020.
Preview |
Text
ers_ACCEPTED.pdf - Accepted Version Download (1MB) | Preview |
Abstract
Objective: Secondary spontaneous pneumothorax (SSP) is traditionally managed with an intercostal chest tube attached to an underwater seal. We investigated whether use of a one-way flutter valve shortened length of patients’ stay (LoS). / Methods: This open-label randomised controlled trial enrolled patients presenting with SSP and randomised to either a chest tube and underwater seal (standard care: SC) or ambulatory care (AC) with a flutter valve. The type of flutter valve used depended on whether at randomisation the patient already had a chest tube in place: in those without a chest tube a Pleural Vent (PV) was used; in those with a chest tube in situ, an Atrium Pneumostat (AP) valve was attached. The primary end-point was LoS. / Results: Between March 2017 and March 2020, 41 patients underwent randomisation: 20 to SC and 21 to AC (13=PV, 8=AP). There was no difference in LoS in the first 30 days following treatment intervention: AC (median=6 days, IQR 14.5) and SC (median=6 days, IQR 13.3). In patients treated with PV there was a high rate of early treatment failure (6/13; 46%), compared to patients receiving SC (3/20; 15%) (p=0.11) Patients treated with AP had no (0/8 0%) early treatment failures and a median LoS of 1.5 days (IQR 23.8). / Conclusion: There was no difference in LoS between ambulatory and standard care. Pleural Vents had high rates of treatment failure and should not be used in SSP. Atrium Pneumostats are a safer alternative, with a trend towards lower LOS.
| Type: | Article |
|---|---|
| Title: | Ambulatory management of secondary spontaneous pneumothorax: a randomised controlled trial |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1183/13993003.03375-2020 |
| Publisher version: | https://doi.org/10.1183/13993003.03375-2020 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10118926 |
Archive Staff Only
 |
View Item |
