Table 6:
Management of Spontaneous Pneumothorax
Primary Spontaneous Pneumothorax
Secondary Spontaneous Pneumothorax
  • Stable patients with small pneumothoraces
    • Observation in the emergency department for 3 to 6 Hours
    • Discharge home if a repeat chest radiograph excludes progression
    • Follow-up within 12-48 hours with repeat chest radiograph to document resolution
  • Stable patients with large pneumothoraces
    • Hospitalization
    • Re-expansion of lung using a small-bore catheter or placing a 16F to 22F chest tube
    • Suction if lung fails to re-expand
  • Unstable patients with large pneumothoraces
    • Hospitalization
    • Chest tube placement with 16F to 22F standard chest tube
    • Use 24F to 28F chest tube if patient has a large air leak or requires positive-pressure ventilation

 

    • All patients should be hospitalized
    • Observation or treatment with a chest tube, depending on the extent of the symptoms and the course of the pneumothorax
 
Copyright 2002 The Cleveland Clinic Foundation

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