Conservative Management of Primary Spontaneous Pneumothorax: Real-World Experience

Recent guidelines advocated for conservative treatment of primary spontaneous pneumothorax (PSP) regardless of size with conditional recommendation.We present audit data from a series of PSP patients managed conservatively.Patients aged 18 to 50 years who presented acutely with first onset unilateral PSP were observed for symptoms, hemodynamic stability and radiological progression of pneumothorax for 4 hours.If stable, they were managed conservatively.Audit of patient outcomes was conducted.Thirty-two patients were assessed.2 patients were lost to follow-up and were excluded.22 males and 8 females were audited.Average size of pneumothorax is 31.4%.7 patients were admitted.Of 7 admissions, 3 had surgery.Average length of stay was 1.2 days.23 (76%) had resolution of PSP without interventions.None returned to ED for life-threatening pneumothorax or haemothorax.Conservative management of PSP regardless of size, can be implemented with favourable patient centric and safety outcomes.