SPLF/SMFU/SRLF/SFAR/SFCTCV Guidelines for the management of patients with primary spontaneous pneumothorax : Endorsed by the French Speaking Society of Respiratory Diseases (SPLF), the French Society of Emergency Medicine (SFMU), the French Intensive Care Society (SRLF), the French Society of Anesthesia & Intensive Care Medicine (SFAR) and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV) - 06/06/23
Doi : 10.1016/j.resmer.2023.100999
Stéphane Jouneau a, ⁎ 
, Jean-Damien Ricard b, Agathe Seguin-Givelet c, Naïke Bigé d, Damien Contou e, Thibaut Desmettre f, Delphine Hugenschmitt g, Sabrina Kepka h, Karinne Le Gloan i, Bernard Maitre j, Gilles Mangiapan k, Sylvain Marchand-Adam l, Alessio Mariolo m, Tania Marx f, Jonathan Messika n, Elise Noël-Savina o, Mathieu Oberlin p, Ludovic Palmier q, Morgan Perruez r, Claire Pichereau s, Nicolas Roche t, Marc Garnier u, Mikaël Martinez v
, Jean-Damien Ricard b, Agathe Seguin-Givelet c, Naïke Bigé d, Damien Contou e, Thibaut Desmettre f, Delphine Hugenschmitt g, Sabrina Kepka h, Karinne Le Gloan i, Bernard Maitre j, Gilles Mangiapan k, Sylvain Marchand-Adam l, Alessio Mariolo m, Tania Marx f, Jonathan Messika n, Elise Noël-Savina o, Mathieu Oberlin p, Ludovic Palmier q, Morgan Perruez r, Claire Pichereau s, Nicolas Roche t, Marc Garnier u, Mikaël Martinez v a Service de Pneumologie, Centre de Compétences pour les Maladies Pulmonaires Rares, IRSET UMR 1085, Université de Rennes 1, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, Rennes 35033, France
b Université Paris Cité, AP-HP, DMU ESPRIT, Service de Médecine Intensive Réanimation, Hôpital Louis Mourier, 178 Rue des Renouillers, 92700 Colombes ; INSERM IAME U1137, Paris, France
c Département de Chirurgie, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, et Université Paris Sorbonne Cité, 42 Bd Jourdan, Paris 75014, France
d Gustave Roussy, Département Interdisciplinaire d'Organisation du Parcours Patient, Médecine Intensive Réanimation, 114 Rue Edouard Vaillant, Villejuif 94805, France
e Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, 69, rue du Lieutenant-colonel Prudhon, Argenteuil 95107, France
f Emergency Department, CHU Besançon, Laboratory Chrono-environnement, UMR 6249 Centre National de La Recherche Scientifique, Université Bourgogne Franche-Comté, 3 Bd Alexandre Fleming, Besançon 25000, France
g Samu-Smur 69, CHU Édouard-Herriot, Hospices Civils de Lyon, 5 Pl. d'Arsonval, Lyon 69003, France
h Emergency Department, Hôpitaux Universitaires de Strasbourg, Icube UMR 7357, 1 place de l'hôpital, Strasbourg BP 426 67091, France
i Emergency Department, centre hospitalier universitaire de Nantes, 5 All. de l'Île Gloriette, Nantes 44000, France
j Service de Pneumologie, Centre hospitalier intercommunal de Créteil, Unité de Pneumologie, GH Mondor, IMRB U 955, Equipe 8, Université Paris Est Créteil, 40 Av. de Verdun, Créteil 94000, France
k Unité de Pneumologie Interventionnelle, Service de Pneumologie, G-ECHO: Groupe ECHOgraphie thoracique, Centre hospitalier intercommunal de Créteil, 40 Av. de Verdun, Créteil 94000, France
l CHRU de Tours, service de pneumologie et explorations respiratoires fonctionnelles, 2, boulevard tonnellé, Tours 37000, France
m Département de Chirurgie, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, 42 Bd Jourdan, Paris 75014, France
n Université Paris Cité, Inserm, Physiopathologie et épidémiologie des maladies respiratoires, Service de Pneumologie B et Transplantation Pulmonaire, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, Paris 75018, France
o Service de pneumologie et soins intensifs respiratoires, G-ECHO: Groupe ECHOgraphie thoracique, CHU Toulouse, 24 Chemin De Pouvourville, Toulouse 31059, France
p Emergency Department, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, Strasbourg BP 426 67091, France
q Pôle Anesthésie Réanimation Douleur Urgences, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, Nîmes 30900, France
r Emergency department, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, Paris 75015, France
s Médecine intensive réanimation, Centre Hospitalier Intercommunal de Poissy Saint Germain, 10 rue du champ Gaillard, Poissy 78300, France
t Service de Pneumologie, Hôpital Cochin, APHP Centre Université Paris Cité, UMR1016, Institut Cochin, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France
u Sorbonne Université, AP-HP, GRC29, DMU DREAM, service d'anesthésie-réanimation et médecine périoperatoire Rive Droite, site Tenon, 4 Rue de la Chine, Paris 75020, France
v Pôle Urgences, centre hospitalier du Forez, & Groupement de coopération sanitaire Urgences-ARA, Av. des Monts du Soir, Montbrison 42600, France
⁎Corresponding author.
Abstract |
Introduction |
Primary spontaneous pneumothorax (PSP) is the presence of air in the pleural space, occurring in the absence of trauma and known lung disease. Standardized expert guidelines on PSP are needed due to the variety of diagnostic methods, therapeutic strategies and medical and surgical disciplines involved in its management.
Methods |
Literature review, analysis of literature according to the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology; proposals for guidelines rated by experts, patients, and organizers to reach a consensus. Only expert opinions with strong agreement were selected.
Results |
A large PSP is defined as presence of a visible rim along the entire axillary line between the lung margin and the chest wall and ≥2 cm at the hilum level on frontal chest x-ray. The therapeutic strategy depends on the clinical presentation: emergency needle aspiration for tension PSP; in the absence of signs of severity: conservative management (small PSP), needle aspiration or chest tube drainage (large PSP). Outpatient treatment is possible if a dedicated outpatient care system is previously organized. Indications, surgical procedures and perioperative analgesia are detailed. Associated measures, including smoking cessation, are described.
Conclusion |
These guidelines are a step towards PSP treatment and follow-up strategy optimization in France.
Le texte complet de cet article est disponible en PDF.Keywords : Pneumothorax, Pleura, Outpatient, Minimally invasive, Chest tube
Abbreviations : ACCP, AE, BHD, BSP, BTS, CEP, COPD, CT, CTD, CXR, ERS, Fr, GRADE, IPF, LRA, NA, NSAID, OR, PFTs, PICO, PSP, SAE, SEPAR, SFAR, SFCTCV, SFMU, SNS, SP, SPLF, SRLF, SSP, VAS, VATS
Plan
| Expert Steering Committee: Stéphane Jouneau, Jonathan Messika, Claire Pichereau, Naïke Bigé, Mathieu Oberlin, Mikaël Martinez. |
|
| Organizers: Nicolas Roche, Bernard Maître |
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| Methodology referent: Sylvain Marchand-Adam |
|
| Review group: |
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| For the Scientific Council of the SPLF: Claire Andréjak, Christophe Leroyer, Marine Gosset-Woimant, Bernard Maitre, Marielle Sabatini |
|
| For the Executive Board of the SFMU: Karim Tazarourte, Sandrine Charpentier, Agnès Ricard-Hibon, Pierre-Yves Gueugniaud, Patrick Goldstein, Jeannot Schmidt, Dominique Pateron, Catherine Pradeau, Muriel Vergne, Jean-Paul Fontaine, Tahar Chouihed, Isabelle Boust, Thibaut Desmettre, Florence Dumas, Olivier Ganansia, Yann Penverne, Patrick Ray, Delphine Hugenschmitt, Stéphane Travers, Yann Erick Claessens, Youri Yordanov |
|
| For the Committee on Standards and Assessment of the SRLF: K. Kuteifan (secretary), I. Adda, C. Bailleul, N. Bigé, C. Cerf, P.F. Dequin, J. Duvivier, M. Grimaud, S. Jean, A. Kimmoun, J. Mootien, C. Pichereau, C. Rosolin, F. Schortgen, M. Simon, A. Thille. |
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| For the Scientific Council of the SFCTCV: Pierre Mordant, Laurent Brouchet, Françoise Le Pimpec Barthes, Antoine Legras, Olaf Mercier. |
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| For the Committee on Clinical Standards of the SFAR: Marc Garnier, Alice Blet, Anaïs Caillard, Hélène Charbonneau, Isabelle Constant, Hugues de Courson, Audrey de Jong, Marc-Olivier Fischer, Denis Frasca, Matthieu Jabaudon, Daphné Michelet, Stéphanie Ruiz, Emmanuel Weiss. |
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| For the Executive Board of the SFAR: Pierre Albaladejo, Jean-Michel Constantin, Marc Léone, Karine Nouette-Gaulain, Frédéric Le Saché, Marie-Laure Cittanova, Isabelle Constant, Julien Amour, Hélène Beloeil, Valérie Billard, Marie-Pierre Bonnet, Julien Cabaton, Marion Costecalde, Laurent Delaunay, Delphine Garrigue, Pierre Kalfon, Olivier Joannes-Boyau, Frédéric Lacroix, Olivier Langeron, Sigismond Lasocki, Jane Muret, Olivier Rontes, Nadia Smail, Paul Zetlaoui. |
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| Endorsed by the French Speaking Society of Respiratory Diseases (SPLF), the French Society of Emergency Medicine (SFMU), the French Intensive Care Society (SRLF), the French Society of Anesthesia \046 Intensive Care Medicine (SFAR) and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV). |
© 2023
SPLF and Elsevier Masson SAS. Tous droits réservés.
Vol 83
Article 100999- juin 2023 Retour au numéro
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