Can spontaneous pneumothorax patients be treated by ambulatory care management?
OBJECTIVE
In the Emergency Department, it would be worthwhile to treat pneumothorax patients on an outpatient basis by utilizing a small-calibre catheter and Heimlich valve insertion. We evaluated this treatment and compared it with the closed thoracostomy.


METHODS
In this comparative study, the success rate, complications and recurrence rate of treating spontaneous pneumothorax patients by using a small-calibre catheter and Heimlch valve were compared with those of a similar-sized group treated by closed thoracostomy.


RESULTS
Pneumothorax was successfully treated on an ambulatory basis by using the small-calibre catheter and Heimlch valve in 20 patients (47%); this was less than the 42 patients (89%) who were successfully treated by closed thoracostomy. While no complications were encountered in the group treated using the small-calibre catheter and Heimlich valve, 11 patients in the group treated by closed thoracostomy developed complications. The medical expenses for the treatment involving the small-calibre catheter and Heimlich valve were less than those for closed thoracostomy.


CONCLUSIONS
Prior to the treatment, the patients should be fully informed of the success rate of this treatment and the possibility of requiring closed thoracostomy in the event of treatment failure.
Choi
Sung Hyuk
SH
Department of Emergency Medicine, College of Medicine, Korea University, Seoul, South Korea. kuedchoi@korea.ac.kr
Lee
Sung Woo
SW
Hong
Yun Sik
YS
Kim
Su Jin
SJ
Moon
Jun Dong
JD
Moon
Sung Woo
SW
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000379:methods*; D015505:Chest Tubes / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods; D004630:Emergencies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D013907:Thoracostomy / Q000009:adverse effects / Q000191:economics; D017211:Treatment Failure; D016896:Treatment Outcome