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Spontaneous pneumothorax has historically been treated with insertion of a large-bore chest tube, but smaller chest tubes or simple needle aspirations have recently been recommended. To assess the best strategy for initial management of spontaneous pneumothorax, researchers performed a systematic review and meta-analysis of randomized studies in adults.
A large-bore chest tube was defined as ≥14 French. Immediate efficacy was defined as resolution of symptoms and lung re-expansion for at least 6 to 24 hours after needle aspiration; lung re-expansion and successful chest tube removal within 7 days after chest tube insertion; or ability to be discharged from the emergency department after aspiration or small-bore chest tube insertion.
The autho…