Methodology: 4/5
Usefulness: 3/5

Hallifax RJ, et al. Lancet. 2020 Jul 4;396(10243):39-49.

Question and Methods: This multicentre open label randomized control trial aimed to determine whether primary spontaneous pneumothoraces could be safely and effective managed using ambulatory devices.

Findings: Ambulatory devices were effective at reducing length of hospitalization (0 vs 4 days) and resulted in fewer further pleural procedures (21% vs 35%) at the expense of increased numbers of adverse events (55% vs 39%).

Limitations: Limited enrollment hours increasing risk of recruitment bias, there was variable use of aspiration within the standard care arm, and daily follow up only occurred in the ambulatory arm without counting as readmission.

Interpretation: This study further supports our current practice of using ambulatory pleural devices in stable patients presenting with large primary spontaneous pneumothorax.

By: Dr. Nicholas Schouela

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.