International guidelines | Classification of PSP | Treatment recommendations |
---|---|---|
American College of Chest Physicians consensus statement, 2001.13 | Large >3 cm apex-to-cupola distance, on CXR. | ICD for clinically unstable or large PSP. |
Belgian Society of Pneumology guidelines, 2005.14 | Large with lung dehiscence over the whole length of lateral chest wall on CXR. | Observation for small and minimally symptomatic PSP, NA or small-bore ICD for symptomatic and/or large PSP. |
Spanish Society of Pulmonology and Thoracic Surgery guidelines, 2008.12 | Partial, complete and complete with total lung collapse on CXR. | NA or small-bore ICD for patients with breathlessness or complete PSP. |
Japan Society for Pneumothorax and Cystic Lung Diseases guidelines, 2009.15 | Mild, moderate and severe according to the degree of collapsed lung on CXR. | Observation or NA for mild PSP, ICD for moderate to severe PSP. |
British Thoracic Society Pleural Diseases guidelines, 2010.9 | Large >2cm at the level of hilum, on CXR. | NA as first intervention for large PSP and/or breathless patients. |
European Respiratory Society Task Force consensus statement, 2015.16 | Not available. | NA or small-bore ICD attached to one-way valve, as first intervention. |
CXR = chest X-ray; ICD = intercostal drain; NA = needle aspiration; PSP = primary spontaneous pneumothorax.