Conservative

For a primary spontaneous pneumothorax (PSP) (in a person with no underlying lung disease) with a visible rim of >2 cm between the lung margin and the chest wall (at the level of the hilum) on a chest radiograph, current guidelines recommend aspiration with a 16–18-gauge cannula and insertion of a small-bore chest drain (8–14 French) if the pneumothorax size cannot successfully be reduced below the 2 cm rim or the patient remains breathless [1]. As interventional management of PSP is associated with potential complications and a patient with a chest drain needs to be admitted to hospital, evaluation of conservative management as a potential alternative to interventional management of larger PSPs is desirable. Before the current trial, there were a few observational studies suggesting that moderate to large sized PSPs can potentially be successfully managed without intervention but evidence from randomised trials was lacking [2]. The PSP trial aimed to determine whether conservative management is an acceptable alternative to interventional management for uncomplicated, moderate-to-large PSP [3].
Conservative management (with a treatment escalation plan in case the patient deteriorates) is a safe alternative to interventional management of a primary spontaneous pneumothorax https://bit.ly/3fIN4uh