Complications during chest tube drainage for iatrogenic pneumothorax
Background Iatrogenic pneumothorax is a common complication of diagnostic and therapeutic pulmonary procedures. New guidelines on primary spontaneous pneumothorax suggest ambulatory approaches may be suitable. However, guidance on iatrogenic pneumothorax occurring in patients with impaired lung func...
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Taylor & Francis Group
2025-12-01
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| Series: | European Clinical Respiratory Journal |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20018525.2025.2453255 |
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| author | Birgitte Siem Joensen Uffe Bodtger Christian B. Laursen Rob J Hallifax Beenish Iqbal Søren Helbo Skaarup |
| author_facet | Birgitte Siem Joensen Uffe Bodtger Christian B. Laursen Rob J Hallifax Beenish Iqbal Søren Helbo Skaarup |
| author_sort | Birgitte Siem Joensen |
| collection | DOAJ |
| description | Background Iatrogenic pneumothorax is a common complication of diagnostic and therapeutic pulmonary procedures. New guidelines on primary spontaneous pneumothorax suggest ambulatory approaches may be suitable. However, guidance on iatrogenic pneumothorax occurring in patients with impaired lung function, increased age, comorbidity and frailty is lacking, and the safety profile of ambulatory management is not known. The objective was to study the safety of iatrogenic pneumothorax treated with chest tubes and to identify the risks of life-threatening events.Methods In a retrospective cohort of patients admitted and treated with an adhesive valve-integrated chest tube system, we recorded the incidence of complications. The primary outcome was the incidence of life-threatening events that required urgent medical action. Incidences of serious adverse events, adverse events, serious device-related events and whether outpatient ambulatory treatment would be safe were recorded based on the review of the medical charts.Results In 97 patients, 6 (6%) life-threatening events occurred, including episodes of respiratory failure and an urgent need for new chest tube insertion. The event incidence was 21% in patients with pre-biopsy saturation below 95% and 1% in patients with saturation above 95%, p = 0.003, and greater if the lung had not expanded on the first radiograph, 25%, after insertion of the chest tube, than if the lung had fully expanded, 4%, or partially expanded, 2%, p = 0.009.Conclusions The incidence of life-threatening events during chest tube-treated iatrogenic pneumothorax is significant, but acceptable in patients without impaired lung function prior to the procedure and early response to treatment. |
| format | Article |
| id | doaj-art-f8c0517df2c74c3d905b03ac9b1a36dd |
| institution | Kabale University |
| issn | 2001-8525 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Clinical Respiratory Journal |
| spelling | doaj-art-f8c0517df2c74c3d905b03ac9b1a36dd2025-01-21T02:55:27ZengTaylor & Francis GroupEuropean Clinical Respiratory Journal2001-85252025-12-0112110.1080/20018525.2025.2453255Complications during chest tube drainage for iatrogenic pneumothoraxBirgitte Siem Joensen0Uffe Bodtger1Christian B. Laursen2Rob J Hallifax3Beenish Iqbal4Søren Helbo Skaarup5Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, DenmarkRespiratory Research Unit (PLUZ), Department of Internal and Respiratory Medicine, Zealand University Hospital, Roskilde & Naestved, DenmarkDepartment of Respiratory Medicine, Odense University Hospital, Odense, DenmarkOxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UKOxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, DenmarkBackground Iatrogenic pneumothorax is a common complication of diagnostic and therapeutic pulmonary procedures. New guidelines on primary spontaneous pneumothorax suggest ambulatory approaches may be suitable. However, guidance on iatrogenic pneumothorax occurring in patients with impaired lung function, increased age, comorbidity and frailty is lacking, and the safety profile of ambulatory management is not known. The objective was to study the safety of iatrogenic pneumothorax treated with chest tubes and to identify the risks of life-threatening events.Methods In a retrospective cohort of patients admitted and treated with an adhesive valve-integrated chest tube system, we recorded the incidence of complications. The primary outcome was the incidence of life-threatening events that required urgent medical action. Incidences of serious adverse events, adverse events, serious device-related events and whether outpatient ambulatory treatment would be safe were recorded based on the review of the medical charts.Results In 97 patients, 6 (6%) life-threatening events occurred, including episodes of respiratory failure and an urgent need for new chest tube insertion. The event incidence was 21% in patients with pre-biopsy saturation below 95% and 1% in patients with saturation above 95%, p = 0.003, and greater if the lung had not expanded on the first radiograph, 25%, after insertion of the chest tube, than if the lung had fully expanded, 4%, or partially expanded, 2%, p = 0.009.Conclusions The incidence of life-threatening events during chest tube-treated iatrogenic pneumothorax is significant, but acceptable in patients without impaired lung function prior to the procedure and early response to treatment.https://www.tandfonline.com/doi/10.1080/20018525.2025.2453255PneumothoraxAmbulatory managementSafety |
| spellingShingle | Birgitte Siem Joensen Uffe Bodtger Christian B. Laursen Rob J Hallifax Beenish Iqbal Søren Helbo Skaarup Complications during chest tube drainage for iatrogenic pneumothorax European Clinical Respiratory Journal Pneumothorax Ambulatory management Safety |
| title | Complications during chest tube drainage for iatrogenic pneumothorax |
| title_full | Complications during chest tube drainage for iatrogenic pneumothorax |
| title_fullStr | Complications during chest tube drainage for iatrogenic pneumothorax |
| title_full_unstemmed | Complications during chest tube drainage for iatrogenic pneumothorax |
| title_short | Complications during chest tube drainage for iatrogenic pneumothorax |
| title_sort | complications during chest tube drainage for iatrogenic pneumothorax |
| topic | Pneumothorax Ambulatory management Safety |
| url | https://www.tandfonline.com/doi/10.1080/20018525.2025.2453255 |
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