RT Journal Article
SR Electronic
T1 Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax: A Cochrane review
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1823
DO 10.1183/13993003.congress-2015.PA1823
VO 46
IS suppl 59
A1 Brian Smith
A1 Abel Wakai
A1 Kristin Carson
A1 Ronan O'Sullivan
A1 Aileen McCabe
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA1823.abstract
AB Background: Spontaneous pneumothorax (SP) management varies. Clinical effectiveness of simple aspiration compared to intercostal tube drainage needs to be systematically evaluated to produce evidence to underpin consistent best clinical practice.Aim: To compare the clinically efficacy, including hospital use and safety of, simple aspiration compared to intercostal tube drainage in the management of primary SP.Method: Two independent researchers screened Medline, CENTRAL, EMBASE, and other resources and bibliographies of randomised controlled studies, up until December 2014, in adults 18 years and older with primary SP. Data abstraction was conducted by two independent researchers.Results: Four studies from 1093 citations met the inclusion criteria (one ongoing). Immediate success rate of procedure (defined by study authors) and early failure rate of procedure (incomplete lung expansion after procedure) did not significantly differ between groups (risk ratio 0.85; 95%CI 0.69-1.06; 245 subjects) and (RR 1.24; 95%CI 0.87-1.75; 245 subjects) respectively. However, statistically significant benefits were observed in favour of aspiration for reducing hospitalisation (RR 0.44; 95%CI 0.34-0.57; p<0.00001; 245 subjects) and reducing length of stay (mean difference -1.61; 95%CI -2.40--0.81; p<0.0001; 197 subjects).Conclusion: Available studies found no significant difference in treatment efficacy between simple aspiration and intercostal tube drainage with respect to immediate success of procedure. However, aspiration was associated with reduced hospitalisation. Methodologically rigorous trials are needed to address outcomes including complications, patient satisfaction and cost.