Pneumothorax complicated by chronic steroid treatment

Eastridge, Charles E.; Hamman, Jack L.

doi:10.1016/s0002-9610(73)80071-6

Cited by 18 publications

(14 citation statements)

References 3 publications

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“…In addition, those patients are usually on corticosteroids, which inhibit the healing process of the injured lung causing persistent air leak. 3 Subsequently, SSP can be hazardous and frequently exhibited as a difficult-to-treat illness.…”

Section: Introductionmentioning

confidence: 99%

Early Autologous Blood-Patch Pleurodesis versus Conservative Management for Treatment of Secondary Spontaneous Pneumothorax

Ibrahim

Elaziz

El-Hag-Aly

2018

Thorac cardiovasc Surg

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Section: Introductionmentioning

confidence: 99%

Early Autologous Blood-Patch Pleurodesis versus Conservative Management for Treatment of Secondary Spontaneous Pneumothorax

Ibrahim

Elaziz

El-Hag-Aly

2018

Thorac cardiovasc Surg

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“…In ILD patients, the distinctive rigidity of lung parenchyma may inhibit reexpansion of the lung. Corticosteroids, which are a frequently-used drug for ILD, may inhibit healing of the injured lung and may cause persistent air leak (7). Moreover, pneumothorax in ILD usually results from progression of underlying disease.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

et al. 2011

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Objective We identified the prognostic relevance of pneumothorax in interstitial lung disease (ILD) patients and evaluated the efficacy and safety of autologous blood-patch pleurodesis. Methods We retrospectively reviewed 59 occurrences of pneumothorax in 34 ILD patients identified over a 12-year period. Results Air leakage ceased in 16 of 22 (72.7%) episodes after blood pleurodesis and in 11 of 14 (78.6%) episodes after chemical pleurodesis. Both the cure ratio and recurrence ratio in the cure episodes were comparable with those in the chemical pleurodesis group (p=0.99 and 0.99, respectively). In addition, there were no harmful events associated with blood pleurodesis. The median survival time after the first episode of pneumothorax was less than 9 months in patients with idiopathic interstitial pneumonia (IIP) and only around 3 years in the patients with other types of ILD, which have essentially favorable outcomes. Kaplan-Meier survival estimates were significantly worse in the patients with concomitant pneumomediastinum than in those without (p<0.05). A multivariate Cox regression analysis identified that the number of episodes of pneumothorax, IIP diagnosis and concomitant pneumomediastinum were independent predictors of death. Conclusion Autologous blood-patch pleurodesis is safe and worth considering as a first-line treatment for pneumothorax secondary to ILD. However, despite treatments, the prognosis after the onset of pneumothorax in ILD patients was found to be poor. In addition, concomitant pneumomediastinum may further worsen the prognosis.

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“…As patients administered methylprednisolone pulse therapy usually have higher disease activity, pneumothorax may be more likely in these patients. In addition, corticosteroids impair the healing process of pneumothorax by decreasing vascular permeability and suppressing the migration of inflammatory cells [ 29 ]. Therefore, corticosteroid use is likely to be associated with refractory pneumothorax; however, the association between corticosteroid use and the onset of pneumothorax remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax in connective tissue disease-associated interstitial lung disease

et al. 2020

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Background Spontaneous pneumothorax is a complication that occurs in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD); however, few studies on the clinical implications of pneumothorax for patients with CTD-ILD have been performed. Objectives This study aimed to investigate the incidence and prognostic significance of pneumothorax and the risk factors for its onset in patients with CTD-ILD. Methods This study included 140 consecutive patients with CTD-ILD. Clinical characteristics, laboratory findings, pulmonary function test results, and chest high-resolution computed tomography (HRCT) images were retrospectively evaluated. Results A total of 18 patients (12.9%) developed pneumothorax during their clinical course. The cumulative incidence of pneumothorax from the time of CTD-ILD diagnosis was 6.5%, 8.7%, and 11.3% at 1, 3, and 5 years, respectively. The 10-year survival rate was significantly lower in patients with pneumothorax (29.6%) than that in those without pneumothorax (81.3%). The development of pneumothorax was significantly associated with poor prognosis (HR 22.0; p < 0.010). Furthermore, a lower body mass index, greater extent of reticular abnormalities on HRCT, and administration of methylprednisolone pulse therapy were significantly associated with the development of pneumothorax. Conclusion Pneumothorax is a serious complication in the clinical course of patients with CTD-ILD and the onset of pneumothorax predicts a poor outcome.

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Pneumothorax complicated by chronic steroid treatment

Cited by 18 publications

References 3 publications

Early Autologous Blood-Patch Pleurodesis versus Conservative Management for Treatment of Secondary Spontaneous Pneumothorax

Early Autologous Blood-Patch Pleurodesis versus Conservative Management for Treatment of Secondary Spontaneous Pneumothorax

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

Pneumothorax in connective tissue disease-associated interstitial lung disease

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