Pneumothorax

Patients with a primary spontaneous pneumothorax should understand that they are at higher risk of ipsilateral and contralateral pneumothoraces than the general population in the future. They should also be made aware that each recurrence increases their risk for subsequent ipsilateral pneumothoraces and that pleurodesis treatment can fail. These patients should, therefore, be instructed to seek immediate medical evaluation should their symptoms recur.

Patients with a secondary spontaneous pneumothorax should also be advised that each recurrence increases their risk for subsequent ipsilateral pneumothoraces. The patient should also be made aware that their underlying lung disease may result in a contralateral pneumothorax and that pleurodesis treatment can fail. The patient should be instructed to seek immediate medical attention should their symptoms recur.

Cigarette smoking increases the risk of recurrence. Thus smoking cessation should be advised.

Patients should be counseled regarding the dangers of sudden barometric pressure changes that might occur with high-altitude activity or underwater diving. Patients who have had a pneumothorax should be discouraged from underwater diving permanently, unless a definitive preventive procedure has been accomplished. Patients should be instructed not to fly for at least 1 week after full resolution of a pneumothorax.[94]Coker RK, Armstrong A, Church AC, et al. BTS clinical statement on air travel for passengers with respiratory disease. Thorax. 2022 Apr;77(4):329-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938676 http://www.ncbi.nlm.nih.gov/pubmed/35228307?tool=bestpractice.com ​ However, the risk of a recurrence in a patient who has had a secondary spontaneous pneumothorax is not significantly reduced until 1 year has passed. In the lack of a definitive preventive procedure, patients should be advised to minimize their risk by avoiding air travel accordingly.