Eur J Cardiothorac Surg 2007;32:183. doi:10.1016/j.ejcts.2007.03.034
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Can spontaneous pneumothorax patients be treated by ambulatory care management? Revisited
Mohamed Fouad Ismail*
Mansoura University Hospitals, 71 El-Sedek St., Ahmed Maher St., Mansoura, Egypt
Received 16 March 2007;
accepted 23 March 2007.
* Corresponding author. Tel.: +20 50 2266741; fax: +20 50 2234111. (Email: mfismail2299{at}yahoo.com).
Key Words: Spontaneous pneumothorax • Heimlich valve • Closed thoracostomy
I read with interest the article titled ‘Can spontaneous pneumothorax patients be treated by ambulatory care management?’ [1], but I have some comments about it.
- 1. I think that cost increase with Heimlich valve are not as have been mentioned before, as the failure rate of those patients using the method need an additional conventional method, which adds to the primary cost.
- 2. I do not understand why two routes for catheter insertion were performed using a needle inserted into the fifth intercostal space in the anterior axillary line or the second intercostal space in the midclavicular line. I think it was better to use only one route for comparison, unless there were other indications for the two different routes.
- 3. It is a routine in our institute to insert closed thoracostomy tube for those patients with spontaneous pneumothorax; and when the lung is fully inflated the patient can go home even on the day of insertion. He can be followed with regular chest X-ray in our outpatient clinic.
- 4. I can suspect that the higher rate of failure with the Heimlich valve was due to the small caliber of the catheter used. A more wider catheter can help for drainage of larger pneumothorax.
- 5. I have one more last comment about the recurrence rate which was calculated only during the first 6 months. I think that this time is not enough for assessment of the recurrence rate.
References
- Choi SH, Lee SW, Hong YS, Kim SJ, Moon JD, Moon SW. Can spontaneous pneumothorax patients be treated by ambulatory care management?. Eur J Cardiothorac Surg 2007;31:491-495.[Abstract/Free Full Text]
