Evaluation of Simple Aspiration Therapy in the Initial Treatment for Primary Spontaneous Pneumothorax

Nishiuma, Teruaki; Ohnishi, Hisashi; Katsurada, Naoko; Yamamoto, Shiro; Yoshimura, Sho; Kinami, Saori

doi:10.2169/internalmedicine.51.6919

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…This was in agreement with the Australian guidelines (44). Furthermore, Nishiuma and his colleagues (45) held the view that needle aspiration should be considered as the first choice in the management of mild and moderate PSP ("mild" was defined as the pneumothorax cranial to the level of collarbone area; "moderate" referred to intermediate between mild and severe pneumothorax; and "severe" was defined as the pneumothorax with completely collapsed lung), opposite to the view of Kuester (46). Low success rate of needle aspiration was the shortcoming pointed out most frequently.…”

Section: Discussionsupporting

confidence: 87%

Chest tube drainage versus needle aspiration for primary spontaneous pneumothorax: which is better?

et al. 2017

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Background: Needle aspiration and chest tube drainages are two main treatments for primary spontaneous pneumothorax (PSP). However, the application of needle aspiration or chest tube drainages has not reached a consensus. The aim of this study is to compare the needle aspiration with chest tube drainages in patients suffering with PSP and therefore help offer suggestions for clinical practice. and risk ratio (RR) respectively, and each with 95% confidence intervals (CIs). We used the fixed effect or random effect model to perform quantitative synthesis.Results: A total of 6 RCTs recruiting 458 participants were included in our analysis. On the basis of the six studies, our results indicated that compared with chest tube drainage applying needle aspiration shortened the hospital stay (WMD: -1.67 days; 95% CI: -2.25 to 1.08; P<0.001) and decreased hospitalization rate (RR: 0.40; 95% CI: 0.22-0.75; P=0.004). However, there was no difference regarding immediate success rate (RR: 1.01; 95% CI: 0.70-1.46; P=0.96) and one-year recurrence rate (RR: 0.89; 95% CI: 0.58-1.38; P=0.61). Conclusions:In the light of this present research, it is necessary to apply needle aspiration into treating PSP to reduce hospitalization rate and shorten hospital stay. However, the two treatments have no significant difference with respect to immediate success rate, one-year recurrence rate, one-week success rate, three-month recurrence rate or complication rate.

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Section: Discussionsupporting

confidence: 87%

Chest tube drainage versus needle aspiration for primary spontaneous pneumothorax: which is better?

et al. 2017

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“…Clinical study AL-ALAWI [17] AL-MOURGI [18] ANDERSEN [19] CASALI [10] CHAN [12] CHEN [20] CHEN [21] CHEN [22] GANESALINGAM [9] HARVEY [23] KARASAKI [25] KIM [26] KUAN [27] LICHTER [28] LIGHT [29] MARTÍNEZ-RAMOS [30] MEHTA [31] NISHIUMA [32] NOH [33] NOH [34] OLESEN [6] OUANES-BESBES [13] PRIMAVESI [8] SADIKOT [ due to nutritional deficiencies affecting α 1 -antitrypsin levels or due to unbalanced physical development, was supported by two papers [5,6,[44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Recurrence rates in primary spontaneous pneumothorax: a systematic review and meta-analysis

et al. 2018

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Primary spontaneous pneumothorax (PSP) recurrence rates vary widely in the published literature, with limited data describing the factors that influence recurrence. The aims of this systematic review were to determine an estimation of PSP recurrence rates and describe risk factors for recurrence.A systematic review was conducted of all studies reporting PSP recurrence. Electronic searches were performed to identify English language publications of randomised trials and observational studies. The population was adults with PSP, who underwent conservative management, pleural aspiration or chest drainage. The outcome of interest was recurrence. Articles were screened and data extracted from eligible studies by two reviewers.Of 3607 identified studies, 29 were eligible for inclusion, comprising 13 548 patients. Pooled 1-year and overall recurrence rates were 29.0% (95% CI 20.9-37.0%) and 32.1% (95% CI 27.0-37.2%), respectively. Female sex was associated with increased recurrence (OR 3.03, 95% CI 1.24-7.41), while smoking cessation was associated with a four-fold decrease in risk (OR 0.26, 95% CI 0.10-0.63). for random effects meta-analysis was 94% (p<0.0001), reflecting high heterogeneity between studies.This systematic review demonstrates a 32% PSP recurrence rate, with greatest risk in the first year. Female sex was associated with higher risk, suggesting possible sex-specific pathophysiology.

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“…Invasive treatment is usually required as initial management when a PTX is large or accompanied by significant symptoms. Although ITD has been preferred as the standard invasive therapy, recent studies have reported that aspiration and catheterization connected to a one-way valve were also effective for re-expanding a collapsed lung and had similar recurrence rates [6–8]. …”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods

Kim

Park

et al. 2017

PLoS ONE

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ObjectivesThe ideal invasive management as initial approach for pneumothorax (PTX) is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults.MethodsThree databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included. The primary outcome was the early success rate of each method, and the risk ratios (RRs) were used for an effect size measure. The secondary outcomes were recurrence rate, hospitalization rate, hospital stay, and complications.ResultsSeven studies met our inclusion criteria. Interventions were aspiration in six studies and catheterization connected to a one-way valve in one study. Meta-analyses were conducted for early success rate, recurrence rate, hospitalization rate, and hospital stay. Aspiration was inferior to intercostal tube drainage in terms of early success rate (RR = 0.82, confidence interval [CI] = 0.72 to 0.95, I2 = 0%). While aspiration and intercostal tube drainage showed no significant difference in the recurrence rate (RR = 0.84, CI = 0.57 to 1.23, I2 = 0%), aspiration had shorter hospital stay than intercostal tube drainage (mean difference = -1.73, CI = -2.33 to -1.13, I2 = 0%). Aspiration had lower hospitalization rate than intercostal tube drainage, but marked heterogeneity was present (RR = 0.38, CI = 0.19 to 0.76, I2 = 85%).ConclusionAspiration was inferior to intercostal tube drainage in terms of early resolution, but it had shorter hospital stay. The recurrence rate of aspiration and intercostal tube drainage did not differ significantly. The efficacy of catheterization connected to a one-way valve was inconclusive because of the small number of relevant studies.(Registration of study protocol: PROSPERO, CRD42016037866)

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Evaluation of Simple Aspiration Therapy in the Initial Treatment for Primary Spontaneous Pneumothorax

Cited by 17 publications

References 14 publications

Chest tube drainage versus needle aspiration for primary spontaneous pneumothorax: which is better?

Chest tube drainage versus needle aspiration for primary spontaneous pneumothorax: which is better?

Recurrence rates in primary spontaneous pneumothorax: a systematic review and meta-analysis

Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods

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