Pneumothorax: treatment by small-lumen catheter aspiration

Aust N Z J Med. 1990 Dec;20(6):775-81. doi: 10.1111/j.1445-5994.1990.tb00422.x.


To assess the efficacy of simple aspiration as a treatment for pneumothorax, 40 consecutive pneumothoraces (28 spontaneous, 12 iatrogenic, all estimated at greater than or equal to 20% collapse on visual inspection of the chest X-ray) in 38 symptomatic patients were treated initially by small-lumen catheter (SLC) aspiration. SLC aspiration avoided the need for large-lumen intercostal catheter (LIC) underwater drainage in 28 cases (70%)--20 of 28 spontaneous and eight of 12 iatrogenic pneumothoraces. Outcome was not predicted by clinical variables or pneumothorax size, whereas an initial aspirate volume of less than or equal to 4 L (n = 33) was predictable of success in 28 cases (85%). Minor local subcutaneous emphysema and vasovagal reactions were encountered infrequently but with similar frequency to LIC drainage. No episodes of re-expansion pulmonary oedema occurred. The results confirm previous reports of the efficacy of simple aspiration as a treatment for spontaneous or iatrogenic pneumothorax. Initial treatment by SLC aspiration is recommended for all but life-threatening presentations of pneumothorax. Although not encountered in this study, the potential risk of re-expansion pulmonary oedema suggests that patients should be observed closely for four hours after aspiration.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Catheterization, Peripheral
  • Drainage
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pneumothorax / surgery*
  • Pneumothorax / therapy
  • Pulmonary Emphysema / etiology
  • Regression Analysis
  • Suction / adverse effects
  • Suction / economics
  • Suction / methods*