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Fantin A, Castaldo N, Salvitti S, Crisafulli E, Sartori G, Patrucco F, Vailati P, Morana G, Patruno V, Aujayeb A. A Practical Approach to Pneumothorax Management. Pulm Ther 2025; 11:327-346. [PMID: 40299308 PMCID: PMC12102440 DOI: 10.1007/s41030-025-00297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Accepted: 04/07/2025] [Indexed: 04/30/2025] Open
Abstract
Pneumothorax, defined by the presence of air in the pleural cavity, is a potentially life-threatening condition requiring prompt diagnosis and tailored management. Rapid and accurate diagnosis is primarily achieved through radiological imaging. Management strategies for pneumothorax vary according to severity and aetiology. Conservative care, involving vigilant observation and supplemental oxygen, is suitable for small, stable pneumothoraxes. Needle aspiration can be an effective first-line treatment, although it may fail in some instances, necessitating escalation. Ambulatory devices facilitate outpatient care and reduce the length of hospital stays. Chest drainage remains a cornerstone therapy. Indwelling pleural catheters may be implemented in selective cases. Endobronchial treatments, including valves and spigots, offer minimally invasive options for reducing the flow of air leaks. Medical thoracoscopy with talc poudrage provides both diagnostic and therapeutic benefits in patients unsuitable for surgery, while surgical intervention represents the gold standard for definitive treatment. Adjunctive interventions include talc slurry pleurodesis and autologous blood patch pleurodesis for patients unsuitable for surgery. Effective management necessitates individualized treatment plans, incorporating risk factor modification, pain management, and physiotherapy. This practical approach aims to update the reader on the treatment modalities that can be used in all forms of pneumothorax in clinical practice.
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Affiliation(s)
- Alberto Fantin
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy.
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| | - Nadia Castaldo
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy
| | - Simone Salvitti
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy
| | - Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giulia Sartori
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Filippo Patrucco
- Division of Respiratory Diseases, Department of Medicine, Maggiore della Carità University Hospital, Novara, Italy
| | - Paolo Vailati
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy
| | - Giuseppe Morana
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy
| | - Vincenzo Patruno
- Department of Pulmonology, Santa Maria della Misericordia University Hospital, Via Colugna, 33100, Udine, UD, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
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Johansen KB, Valtersson J, Laursen CB, Mussmann B, Rasmussen B, Graumann O, Pietersen PI. Diagnostic yield and complications of CT-guided biopsy of lung lesions as a radiological outpatient clinic procedure. Acta Radiol Open 2025; 14:20584601251326485. [PMID: 40124552 PMCID: PMC11926819 DOI: 10.1177/20584601251326485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/18/2025] [Indexed: 03/25/2025] Open
Abstract
Background Computerized tomography-guided transthoracic needle biopsy (CT-TTNB) plays an important role in the diagnostic work-up of lung lesions. The literature reports varying results on complication rates, severity of complications, and diagnostic yield. Purpose To evaluate CT-TTNB as a radiological outpatient clinic procedure and explore diagnostic yield and complication rates. Material and methods Between January 2017 and October 2019, a total of 559 patients underwent CT-TTNB. Patient records and CT scans were retrospectively reviewed and patient characteristics, lesion characteristics, biopsy procedure, and per- and post-procedural complications, as well as pathological diagnosis, were registered. Results Of 559 patients included, 511 had biopsies performed. Thereby, 48 biopsies (8.6%) were discontinued because of patient compliance issues and/or the occurrence of pneumothorax before the biopsy was performed. The overall pneumothorax rate was 49.2% (n = 275 of 559 patients). Insertion of a drainage catheter was needed in 85 of the 275 patients with pneumothorax. Parenchymal bleeding was seen in 26.5% of the patients and haemoptysis in 5.5%. No cases of bleeding or haemoptysis required intervention or admission. Small mean lesion size and increased distance from pleura to the lesion were associated with a higher occurrence of complications. A conclusive pathological diagnosis was obtained in 278 of 511 (54.4%) biopsies. No patients were re-admitted after the two-hour observational period in the radiological department. Conclusion CT-TTNB as an outpatient clinic procedure is feasible but has a moderate diagnostic yield and relatively high complication rates for minor complications.
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Affiliation(s)
- Katrine Bitsch Johansen
- UNIFY – Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - John Valtersson
- UNIFY – Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christian B. Laursen
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
- ODIN - Research Unit, Department of Respiratory Medicine, University of Southern Denmark, Odense, Denmark
| | - Bo Mussmann
- UNIFY – Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Odense University Hospital, Odense Denmark
| | - Benjamin Rasmussen
- UNIFY – Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Odense University Hospital, Odense Denmark
| | - Ole Graumann
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
- Research Unit of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Iben Pietersen
- UNIFY – Research and Innovation Unit of Radiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Odense University Hospital, Odense Denmark
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Iqbal B, Choi HJ, Kanellakis NI, Akulian J, Rahman NM. Bedside to bench and back again-translational research in interventional pulmonology. Curr Opin Pulm Med 2025; 31:59-64. [PMID: 39412040 PMCID: PMC11623379 DOI: 10.1097/mcp.0000000000001125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2024]
Abstract
PURPOSE OF REVIEW Translational research in Interventional Pulmonology has made significant advances in recent years, ranging from novel biomarkers and imaging to practice-changing clinical trials in lung cancer and pleural disease. This review article aims to summarize key research studies in the field to understand the latest published evidence and to highlight areas of growing academic interest. RECENT FINDINGS In lung cancer, the role of novel imaging and biomarkers and their potential utility in early lung cancer diagnosis will be highlighted. In pleural disease, less invasive/conservative treatment in pneumothorax, early aggressive treatment in pleural infection along with novel biomarkers, and the shift beyond drainage strategies in malignant pleural effusion and mesothelioma will be discussed. SUMMARY This overview of translational research in the field of interventional pulmonology will ultimately help to highlight the gaps in current evidence to promote research in areas of clinical significance.
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Affiliation(s)
- Beenish Iqbal
- Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
| | - Hee Jae Choi
- PGY-5, Division of Pulmonary and Critical Care, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Jason Akulian
- Interventional Pulmonology and Pulmonary Oncology, Division of Pulmonary and Critical Care, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Najib M. Rahman
- Professor of Respiratory Medicine, Director Oxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Walker S, Taylor E, McAndrew A, Carlton E, Chaudhuri E, Ghorpade P, Goodwin C, Connors J, Cook H, Luengo-Fernandez R, Creanor S, Maskell NA. Pragmatic non-inferiority Randomised trial Investigating Needle aspiration versus ChEst drain for Secondary Spontaneous Pneumothorax (the PRINCE-SSP study): study protocol for a randomised non-inferiority trial. BMJ Open 2024; 14:e093700. [PMID: 39725415 PMCID: PMC11683926 DOI: 10.1136/bmjopen-2024-093700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 12/05/2024] [Indexed: 12/28/2024] Open
Abstract
INTRODUCTION Secondary spontaneous pneumothorax (SSP) is a medical emergency where the lung collapses in the presence of underlying chronic lung disease. Current international clinical guidelines advise intercostal drain (ICD) insertion for SSP. However, in a previous small study needle aspiration (NA) has been shown to reduce length of hospital stay (LOHS) and reduce complications. We are evaluating the clinical and cost-effectiveness of an initial NA approach to the management of patients with SSP in the United Kingdom. METHODS AND ANALYSIS The PRINCE-SSP (Pragmatic non-inferiority Randomised trial Investigating Needle aspiration vs ChEst drain for Secondary Spontaneous Pneumothorax) trial is a pragmatic, multicentre, open-label, parallel, two-group, randomised, non-inferiority trial to establish whether NA for SSP is non-inferior in terms of LOHS compared with ICD. We aim to recruit 110 patients from at least 15 UK NHS hospitals, over 18 months. Participants allocated to the intervention (NA) group will have an NA inserted at the presentation. Those allocated to the comparator (usual care) group will have an ICD inserted. Participants are followed up for 30 days. The primary outcome measure is initial LOHS, up to day 30 postrandomisation. Secondary outcomes include (but are not limited to) total LOHS including readmissions, complications, cost-effectiveness and patient-reported quality of life. ETHICS AND DISSEMINATION This trial received Health Research Authority (HRA) approval from Wales Research Ethics Committee seven ethics committee (23/WA/0085). Results will be submitted for publication in a peer-reviewed journal. A plain English summary of the trial results will be prepared and disseminated with the help of our patient advisory group, including via social media, and provided to trial participants via post or email according to their preference. TRIAL REGISTRATION NUMBER ISRCTN12644940.
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Affiliation(s)
- Steven Walker
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
| | - Ellie Taylor
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | - Amy McAndrew
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | - Edward Carlton
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
- University of Bristol, Bristol, UK
| | | | - Pooja Ghorpade
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | | | - James Connors
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | - Heather Cook
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | | | - Siobhan Creanor
- Exeter Clinical Trials Unit, University of Exeter, Exeter, UK
| | - Nick A Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
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Porcel JM, Lee YCG. Advances in pleural diseases. Eur Respir J 2024; 63:2400593. [PMID: 38901889 DOI: 10.1183/13993003.00593-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/03/2024] [Indexed: 06/22/2024]
Affiliation(s)
- José M Porcel
- Pleural Medicine and Clinical Ultrasound Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, University of Lleida, Lleida, Spain
| | - Y C Gary Lee
- University of Western Australia; Institute for Respiratory Health and Respiratory Department, Sir Charles Gairdner Hospital, Perth, Australia
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Cheng J, Ma A, Liang G. Simple aspiration for spontaneous pneumothorax in adults: A systematic review and meta-analysis of randomized controlled trials. Am J Emerg Med 2024; 80:99-106. [PMID: 38537340 DOI: 10.1016/j.ajem.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Spontaneous pneumothorax (SP) is a widespread clinical entity, and methods of managing adult SP remain controversial. The aim of this meta-analysis was to further determine the clinical efficacy and safety of simple aspiration (SA) in comparison to intercostal tube drainage (ITD) during the management of adult SP. METHODS EMBASE, Medline and the Cochrane Central Register of Controlled Trials via Ovid SP were searched (to June 2023) to identify randomized controlled trials (RCT) that reported outcomes of interest after comparing SA with ITD for the management of adult SP. RESULTS The search strategy yielded 1447 citations, of which 10 RCTs enrolling 1044 subjects were included. Compared with the ITD group, the SA group had a significantly lower the initial success rate of the procedure for the management of SP (OR 0.63, 95% CI [0.47-0.86]; P = 0.004). Moreover, SA was associated with a decreased duration of hospitalization (mean difference-2.05 days, 95% CI [-2.66 - -1.44]; P < 0.001) and a decreased need for operation (P = 0.03). For frequently reported adverse events such as subcutaneous emphysema (P = 0.32), bleeding (P = 0.0.26) and wound infection (P = 0.07), no significant difference between the SA and ITD groups was found. There was no significant difference for other outcomes. Subgroup analysis found that there was no significant difference between SA and ITD in terms of the initial success rate, 1-week success rate or any type of adverse event for PSP patients. CONCLUSIONS In the management of adult SP, the use of SA decreased the initial success rate but also decreased the duration of hospitalization and the need for operation compared with ITD. The incidence of adverse events did not differ between the two approaches. The research plan was registered at PROSPERO, and the registration number was CRD42023436770.
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Affiliation(s)
- Jiangli Cheng
- Department of Respiratory Care, West China Hospital of Sichuan University, Guoxue Alley 37#, Wuhou District, Chengdu, Sichuan 610041, China
| | - Aijia Ma
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Guoxue Alley 37#, Wuhou District, Chengdu, Sichuan 610041, China
| | - Guopeng Liang
- Department of Respiratory Care, West China Hospital of Sichuan University, Guoxue Alley 37#, Wuhou District, Chengdu, Sichuan 610041, China.
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Zajacova A, Scaramozzino MU, Bellini A, Purwar P, Ricciardi S, Migliore M, Meloni F, Esendagli D. ERS International Congress 2023: highlights from the Thoracic Surgery and Lung Transplantation Assembly. ERJ Open Res 2024; 10:00854-2023. [PMID: 38590936 PMCID: PMC11000272 DOI: 10.1183/23120541.00854-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 04/10/2024] Open
Abstract
Five sessions presented at the European Respiratory Society Congress 2023 were selected by Assembly 8, consisting of thoracic surgeons and lung transplant professionals. Highlights covering management of adult spontaneous pneumothorax, malignant pleural effusion, infectious and immune-mediated complications after lung transplantation, as well as the pro and con debate on age limit in lung transplantation and results of the ScanCLAD study were summarised by early career members, supervised by the assembly faculty.
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Affiliation(s)
- Andrea Zajacova
- Prague Lung Transplant Program, Department of Pneumology, Second Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Marco Umberto Scaramozzino
- Pulmonology “La Madonnina” Reggio Calabria, Reggio Calabria, Italy
- Villa aurora Hospital Reggio Calabria, Reggio Calabria, Italy
| | - Alice Bellini
- Division of Thoracic Surgery, Department of Medical and Surgical Sciences (DIMEC) of the Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Giovanni Battista Morgagni-Luigi Pierantoni Hospital, Forlì, Italy
| | | | - Sara Ricciardi
- Unit of Thoracic Surgery, San Camillo Forlanini Hospital, Rome, Italy
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Marcello Migliore
- Program of Minimally Invasive Thoracic Surgery and New Technologies, Policlinic Hospital, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
- Thoracic Surgery and Lung Transplantation, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Federica Meloni
- Transplant Center, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Dorina Esendagli
- Baskent University, Faculty of Medicine, Chest Diseases Department, Ankara, Turkey
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8
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Shorthose M, Barton E, Walker S. The contemporary management of spontaneous pneumothorax in adults. Breathe (Sheff) 2023; 19:230135. [PMID: 38229681 PMCID: PMC10790175 DOI: 10.1183/20734735.0135-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/18/2024] Open
Abstract
Spontaneous pneumothorax is a common presentation, and there has been a recent surge of research into the condition. With the recent publication of the new British Thoracic Society guidelines and the upcoming European Respiratory Society guidelines, we provide a concise up-to-date summary of clinical learning points. In particular we focus on the role of conservative or ambulatory management, as well as treatment options for persistent air leak and guidance for when to refer to thoracic surgeons for the prevention of the recurrence of pneumothorax. Educational aims To give up-to-date guidance on the acute management of spontaneous pneumothorax, including the role of conservative or ambulatory managementTo discuss the different treatment options for persistent air leak.To guide physicians on when to refer patients to thoracic surgeons for the prevention of the recurrence of pneumothorax.
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Affiliation(s)
| | - Eleanor Barton
- Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK
| | - Steven Walker
- Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK
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Wang W, Zhu DN, Shao SS, Bao J. Closed thoracic drainage in elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax: A retrospective study. World J Clin Cases 2023; 11:6415-6423. [PMID: 37900247 PMCID: PMC10600998 DOI: 10.12998/wjcc.v11.i27.6415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/10/2023] [Accepted: 08/31/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) combined with spontaneous pneumothorax, is characterized by significant decline in lung function, and even cause cardiopulmonary failure and hypoxia. AIM To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters (IPC) in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous pneumothorax. METHODS Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March 2023. The clinical efficacy, complications, hospitalization duration, and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter. Univariate logistic regression was used to analyze the causes of catheter displacement. RESULTS According to our findings, there were significant differences in the IPC group's clinical efficacy, catheter operation time, and lung recruitment time (P < 0.05). Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics, catheter abscission, catheter blockage, and subcutaneous emphysema in the IPC group (P < 0.05). Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse's working years (less than three), Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (less than 15), lack of catheter suture fixation, and the proportion of catheters not fixed twice (P < 0.05). CONCLUSION Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax, indwelling thoracic catheters are more effective than the central venous catheter group. Patients' catheter shedding is influenced by the primary nurse's working years, APACHE II scores, and catheter fixation technique.
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Affiliation(s)
- Wei Wang
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, Huangshan 242700, Anhui Province, China
| | - Dong-Ning Zhu
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, Huangshan 242700, Anhui Province, China
| | - Shan-Shan Shao
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, Huangshan 242700, Anhui Province, China
| | - Jun Bao
- Department of Respiratory and Critical Care Medicine, The People’s Hospital of Shexian, Huangshan 242700, Anhui Province, China
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Hallifax RJ, Iqbal B, Walker SP, Maskell NA, Rahman NM. Aspirating Pneumothorax: Clearing the Air or Muddying the Water? Am J Respir Crit Care Med 2023; 207:1647-1648. [PMID: 37084396 PMCID: PMC10273119 DOI: 10.1164/rccm.202303-0593le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Affiliation(s)
- Rob J Hallifax
- Oxford Respiratory Trials Unit and
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom; and
| | | | - Steven P Walker
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | - Nick A Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | - Najib M Rahman
- Oxford Respiratory Trials Unit and
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom; and
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11
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Lee YCG. Primary Spontaneous Pneumothorax: Treat the Patient, Not the X-Ray. Am J Respir Crit Care Med 2023; 207:1416-1417. [PMID: 36892609 PMCID: PMC10263137 DOI: 10.1164/rccm.202302-0273ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Affiliation(s)
- Y C Gary Lee
- Respiratory Medicine Sir Charles Gairdner Hospital Perth, Western Australia, Australia
- Faculty of Health & Medical Sciences University of Western Australia Perth, Western Australia, Australia and Pleural Medicine Unit Institute for Respiratory Health Perth, Western Australia, Australia
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