Cleared for takeoff

Majercik, Sarah; White, Thomas W.; Boerum, Don H. Van; Granger, Steven R.; Bledsoe, Joseph; Conner, Karen; Wilson, Emily; Weaver, Lindell K.

doi:10.1097/ta.0000000000000441

Cited by 10 publications

(1 citation statement)

References 8 publications

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“…Previous guidance recommends patients who have had a SP must have a chest X-ray to confirm resolution prior to flight and should wait a further 7 days before embarking upon flight [85,86]. Although the risk of readmission within a week of discharge of SP is small and there is evidence that suggests recently treated or small pneumothoraces are unlikely to cause significant issues in patients with normal underlying lung function, this remains pragmatic advice [87,88]. There have been case reports of uncomplicated air travel of patients with chronic pneumothoraces.…”

Section: Summary Of Evidencementioning

confidence: 99%

Joint ERS/EACTS/ESTS clinical practice guidelines on adults with spontaneous pneumothorax

Walker,

Hallifax,

Ricciardi

et al. 2024

Eur Respir J

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BackgroundThe optimal management for spontaneous pneumothorax (SP) remains contentious, with various proposed approaches. This joint clinical practice guideline from the ERS, EACTS and ESTS societies provides evidence-based recommendations for the management of SP.MethodsThis multidisciplinary Task Force addressed 12 key clinical questions on the management of pneumothorax, using ERS methodology for guideline development. Systematic searches were performed in MEDLINE and Embase. Evidence was synthesised by conducting meta-analyses, if possible, or narratively. Certainty of evidence was rated with GRADE (Grading of Recommendations, Assessment, Development and Evaluations). The Evidence to Decision framework was used to decide on the direction and strength of the recommendations.ResultsThe panel makes a conditional recommendation for conservative care of minimally symptomatic patients with primary spontaneous pneumothorax (PSP) who are clinically stable. We make a strong recommendation for needle aspiration over chest tube drain for initial PSP treatment. We make a conditional recommendation for ambulatory management for initial PSP treatment. We make a conditional recommendation for early surgical intervention for the initial treatment of PSP in patients who prioritise recurrence prevention. The panel makes a conditional recommendation for autologous blood patch in secondary SP patients with persistent air leak (PAL). The panel could not make recommendations for other interventions, including bronchial valves, suction, pleurodesis in addition to surgical resection or type of surgical pleurodesis.ConclusionsWith this international guideline, the ERS, EACTS and ESTS societies provide clinical practice recommendations for SP management. We highlight evidence gaps for the management of PAL and recurrence prevention, with research recommendations made.

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