New strategies in the management of pneumothorax.

Abstract

Pneumothorax arises from pulmonary air leaking into the pleural space. If the air leak has healed, the pneumothorax may not require intervention but will take time to resolve. Procedural management may be warranted, despite resolution of the air leak, depending on patient preference. An ongoing air leak carries a risk of tension pneumothorax and requires intervention. Surgical prevention of recurrent pneumothorax should be considered in cases with a second episode or for patient factors (e.g. occupational risk). This review aims to describe the evidence base for the recent paradigm shift towards individualised management in the treatment of pneumothorax, supported by new guidelines, and the utility of novel diagnostic/management adjuncts such as thoracic ultrasound and digital drainage systems.