Étude EXPRED (EXsufflation d’un PREmier pneumothorax versus Drainage) : où en sommes-nous ?

Desmettre, T.; Meurice, J.-C.; Tapponnier, Romain; Pretalli, Jean-Baptiste; Dalphin, Jean Charles

doi:10.1016/j.rmr.2012.09.019

Cited by 7 publications

(1 citation statement)

References 24 publications

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“…Chest tubes were more often used than less invasive equipment such as pleurocath or pigtail catheters, even though small bore chest drains are recommended [1, 25, 26]. Some barriers to the use of less invasive strategies include the lack of reliable specific equipment, low awareness of techniques by physicians who are more accustomed to conventional drainage, or the absence of therapeutic consensus [27]. Currently, the “technical” gap between aspiration and drainage is closing, with various devices that can either be left in place or removed rapidly once the pleural space has been rendered air-free [28].…”

Section: Discussionmentioning

confidence: 99%

How spontaneous pneumothorax is managed in emergency departments: a French multicentre descriptive study

et al. 2019

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BackgroundManagement of spontaneous pneumothorax (SP) is still subject to debate. Although encouraging results of recent studies about outpatient management with chest drains fitted with a one-way valve, no data exist concerning application of this strategy in real life conditions. We assessed how SP are managed in Emergency departments (EDs), in particular the role of outpatient management, the types of interventions and the specialty of the physicians who perform these interventions.MethodsFrom June 2009 to May 2013, all cases of spontaneous primary (PSP) and spontaneous secondary pneumothorax (SSP) from EDs of 14 hospitals in France were retrospectively included. First line treatment (observation, aspiration, thoracic drainage or surgery), type of management (admitted, discharged to home directly from the ED, outpatient management) and the specialty of the physicians were collected from the medical files of the ED.ResultsAmong 1868 SP included, an outpatient management strategy was chosen in 179 PSP (10%) and 38 SSP (2%), mostly when no intervention was performed. Only 25 PSP (1%) were treated by aspiration and discharged to home after ED admission. Observation was the chosen strategy for 985 patients (53%). In 883 patients with an intervention (47%), it was performed by emergency physicians in 71% of cases and thoracic drainage was the most frequent choice (670 patients, 76%).ConclusionsOur study showed the low level of implementation of outpatient management for PS in France. Despite encouraging results of studies concerning outpatient management, chest tube drainage and hospitalization remain preponderant in the treatment of SP.Electronic supplementary materialThe online version of this article (10.1186/s12873-018-0213-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

How spontaneous pneumothorax is managed in emergency departments: a French multicentre descriptive study

et al. 2019

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Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults

Carson‐Chahhoud

Wakai

Agteren

et al. 2017

Cochrane Database of Systematic Reviews

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Available trials showed low to moderate-quality evidence that intercostal tube drainage produced higher rates of immediate success, while simple aspiration resulted in a shorter duration of hospitalization. Although adverse events were reported more commonly for patients treated with tube drainage, the low quality of the evidence warrants caution in interpreting these findings. Similarly, although this review observed no differences between groups when early failure rate, one-year success rate, or hospital admission rate was evaluated, this too needs to be put into the perspective of the quality of evidence, specifically, for evidence of very low and low quality for hospitalization rate and patient satisfaction, respectively. Future adequately powered research is needed to strengthen the evidence presented in this review.

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Prise en charge du premier épisode de pneumothorax spontané

Moubachir

Zaghba

Benjelloun

et al. 2016

Revue des Maladies Respiratoires

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Étude EXPRED (EXsufflation d’un PREmier pneumothorax versus Drainage) : où en sommes-nous ?

Cited by 7 publications

References 24 publications

How spontaneous pneumothorax is managed in emergency departments: a French multicentre descriptive study

How spontaneous pneumothorax is managed in emergency departments: a French multicentre descriptive study

Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults

Prise en charge du premier épisode de pneumothorax spontané

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