>>> [log in to unmask] 03/19/01 05:00 >>>
>Slightly off the original subject Marten, but should you be aspirating large
>pneumothoraces? I find large pneumothoraces inevitably indicate large >leaks, so aspiration is doomed to failure, especially where there is a short
>history i.e. the leak has not had time to seal off/heal and therefore
>re-leaks as soon as the lung re-expands. I reserve aspiration for smaller
>(30% or less) pneumothoraces or those with a longer history (but large ones
>usually present early!).
>Adrian Fogarty
Adrian,
Ive been aspirating large pneumothoracies for several years now - after some anecdotal experience of success. Of the 40 or so Ive done or supervised in that time about 30 - 40% of the complete collapses will reinflate to only a small rim of air or almost fully re-inflated and hold it on a 6 hour x-ray. Having being on the receiving end of a chest drain - I think anything we can do to safely avoid a chest drain should be attempted. It may not be BTS - but I dont believe patient safety is being compromised by this approach.
Craig Ellis
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