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  1. Article ; Online: Cost Utility Analysis of Primary Spontaneous Pneumothorax Management: Another Reason to Choose Outpatient Options?

    Hallifax, Rob J

    Chest

    2023  Volume 164, Issue 4, Page(s) 829–830

    MeSH term(s) Humans ; Ambulatory Care/economics ; Cost-Benefit Analysis ; Drainage ; Pneumothorax/economics ; Pneumothorax/therapy ; Recurrence
    Language English
    Publishing date 2023-10-05
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2023.06.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: COVID-19-Related Pleural Diseases.

    Iqbal, Beenish / Rahman, Najib M / Hallifax, Rob J

    Seminars in respiratory and critical care medicine

    2023  Volume 44, Issue 4, Page(s) 437–446

    Abstract: Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including pneumothorax, pneumomediastinum, and pleural effusion with severe COVID-19 infection ...

    Abstract Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including pneumothorax, pneumomediastinum, and pleural effusion with severe COVID-19 infection have attracted the attention of physicians and are not incidental or due to barotrauma. The complicated course of COVID-19 illness highlights the complex pathophysiological underpinnings of pleural complications. The management of patients with pneumothorax and pneumomediastinum is challenging as the majority require assisted ventilation; physicians therefore appear to have a low threshold to intervene. Conversely, pleural effusion cases, although sharing some similar patient characteristics with pneumothorax and pneumomediastinum, are in general managed more conservatively. The evidence suggests that patients with COVID-19-related pleural diseases, either due to air leak or effusion, have more severe disease with a worse prognosis. This implies that prompt recognition of these complications and targeted management are key to improve outcomes.
    MeSH term(s) Humans ; Pneumothorax/etiology ; Pneumothorax/therapy ; COVID-19/complications ; Mediastinal Emphysema/complications ; Pleural Diseases/etiology ; Pleural Diseases/therapy ; Pleural Effusion/therapy ; Pleural Effusion/complications
    Language English
    Publishing date 2023-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0043-1769616
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: National survey on management of spontaneous pneumothorax from emergency department to specialised treatment: room for improvement.

    Skaarup, Søren Helbo / Laursen, Christian B / Hallifax, Rob J / Iqbal, Beenish / Bødtger, Uffe

    European clinical respiratory journal

    2024  Volume 11, Issue 1, Page(s) 2307648

    Abstract: Introduction: Spontaneous pneumothorax (SP) affects both young, otherwise healthy individuals and older persons with known underlying pulmonary disease. Initial management possibilities are evolving and range from observation to chest tube insertion. SP ...

    Abstract Introduction: Spontaneous pneumothorax (SP) affects both young, otherwise healthy individuals and older persons with known underlying pulmonary disease. Initial management possibilities are evolving and range from observation to chest tube insertion. SP guidelines suggest an individualized approach based on multiple factors such as symptoms, size of pneumothorax, comorbidity and patient preference.
    Aim: With this Danish national survey we aimed to map organization of care including involved specialties, treatment choice, training, and follow-up plans to identify aspects, and optimization of spontaneous pneumothorax management.
    Method: A survey developed by the national interest group for pleural medicine was sent to all departments of emergency medicine, thoracic surgery, respiratory medicine, and to relevant departments of abdominal or orthopaedic surgery.
    Results: The response rate was 75 % (47 of 65). Overall, 21% of responding departments had no guideline for SP management, which was provided by multiple specialties with marked heterogeneity in choice of treatment including tube size, management during admission, and referral procedure to follow-up. Few departments required procedure training, and nearly all of the responders called for improvements in management of pneumothorax.
    Conclusion: This survey suggests that SP management and care is delivered heterogeneously across Danish hospitals with marked difference between respiratory physicians, emergency physicians, general surgeons and thoracic surgeons. It is therefore likely that management is sub-optimal. There is a need for a common Danish SP guideline to ensure optimal treatment across involved specialties.
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2834928-3
    ISSN 2001-8525 ; 1399-3003 ; 2001-8525 ; 0903-1936
    ISSN (online) 2001-8525 ; 1399-3003
    ISSN 2001-8525 ; 0903-1936
    DOI 10.1080/20018525.2024.2307648
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reply to Albert and Dhooria

    Hallifax, Rob J / Walker, Steven P / Maskell, Nick A / Rahman, Najib M

    American journal of respiratory and critical care medicine

    2022  Volume 207, Issue 2, Page(s) 226–227

    Language English
    Publishing date 2022-09-07
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202209-1642LE
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  5. Article: COVID-19-Related Pleural Diseases

    Iqbal, Beenish / Rahman, Najib M. / Hallifax, Rob J.

    Seminars in Respiratory and Critical Care Medicine

    (Pleural Diseases)

    2023  Volume 44, Issue 04, Page(s) 437–446

    Abstract: Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including pneumothorax, pneumomediastinum, and pleural effusion with severe COVID-19 infection ...

    Series title Pleural Diseases
    Abstract Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including pneumothorax, pneumomediastinum, and pleural effusion with severe COVID-19 infection have attracted the attention of physicians and are not incidental or due to barotrauma. The complicated course of COVID-19 illness highlights the complex pathophysiological underpinnings of pleural complications. The management of patients with pneumothorax and pneumomediastinum is challenging as the majority require assisted ventilation; physicians therefore appear to have a low threshold to intervene. Conversely, pleural effusion cases, although sharing some similar patient characteristics with pneumothorax and pneumomediastinum, are in general managed more conservatively. The evidence suggests that patients with COVID-19-related pleural diseases, either due to air leak or effusion, have more severe disease with a worse prognosis. This implies that prompt recognition of these complications and targeted management are key to improve outcomes.
    Keywords COVID-19 ; pleural diseases ; pneumothorax ; pneumomediastinum ; pleural effusion ; complications
    Language English
    Publishing date 2023-07-10
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0043-1769616
    Database Thieme publisher's database

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  6. Article ; Online: Aspirating Pneumothorax: Clearing the Air or Muddying the Water?

    Hallifax, Rob J / Iqbal, Beenish / Walker, Steven P / Maskell, Nick A / Rahman, Najib M

    American journal of respiratory and critical care medicine

    2022  Volume 207, Issue 12, Page(s) 1647–1648

    MeSH term(s) Humans ; Chest Tubes ; Pneumothorax/etiology ; Pneumothorax/therapy
    Language English
    Publishing date 2022-07-10
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202303-0593LE
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  7. Article ; Online: Computed Cardiopulmonography for the Detection of Early Smoking-Related Changes in the Lungs of Young Individuals Who Smoke.

    Redmond, Jennifer L / Kendall, Fiona / Smith, Nicholas M J / Magor-Elliott, Snapper R M / Hallifax, Rob J / Fullerton, Christopher J / Richmond, Graham / Couper, John H / Ritchie, Grant A D / Robbins, Peter A / Petousi, Nayia / Talbot, Nick P

    Chest

    2024  

    Language English
    Publishing date 2024-02-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2024.02.006
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  8. Article ; Online: Management of primary spontaneous pneumothorax: less is more - Authors' reply.

    Hallifax, Rob J / Walker, Steven / Walters, James / Maskell, Nick / Rahman, Najib M

    Lancet (London, England)

    2020  Volume 396, Issue 10267, Page(s) 1973–1974

    MeSH term(s) Humans ; Pneumothorax/therapy
    Language English
    Publishing date 2020-12-30
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(20)32676-3
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  9. Article ; Online: Pneumothorax management: current state of practice in the UK.

    Hallifax, Rob J / Roberts, Mark / Russell, Nicky / Laskawiec-Szkonter, Magda / Walker, Steve P / Maskell, Nick A / Rahman, Najib M

    Respiratory research

    2022  Volume 23, Issue 1, Page(s) 23

    Abstract: Background and objective: Spontaneous pneumothorax is a common pathology but optimal initial treatment regime is not well defined. Treatment options including conservative management, needle aspiration (NA) or insertion of a small-bore chest drain. ... ...

    Abstract Background and objective: Spontaneous pneumothorax is a common pathology but optimal initial treatment regime is not well defined. Treatment options including conservative management, needle aspiration (NA) or insertion of a small-bore chest drain. Recent large randomised controlled trials may change the treatment paradigm: comparing conservative and ambulatory management to standard care, but current guidelines need to be updated. The aim of this study was to assess the current "state of play" in the management of pneumothorax in the UK.
    Methods: Physicians and respiratory healthcare staff were invited to complete an online survey on the initial and subsequent management of pneumothorax.
    Results: This study is the first survey of pneumothorax practice across the UK, which highlights variation in practice: 50% would manage a large primary pneumothorax with minimal symptoms conservatively, compared to only 3% if there were significant symptoms; 64% use suction if the pneumothorax had not resolved after > 2 days, 15% always clamp the chest drain prior to removal; whereas 30% never do. NICE guidance recommends the use of digital suction but this has not translated into widespread usage: only 23% use digital suction to check for resolution of air leak).
    Conclusion: Whilst there has always been allowance for individual clinician preference in guidelines, there needs to be consensus on the optimum management strategy. The challenge the new guidelines face is to design a simple and pragmatic approach, using this new evidence base.
    MeSH term(s) Chest Tubes ; Drainage/methods ; Humans ; Incidence ; Pneumothorax/epidemiology ; Pneumothorax/therapy ; United Kingdom/epidemiology
    Language English
    Publishing date 2022-02-07
    Publishing country England
    Document type Letter
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-022-01943-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Predicting outcomes in primary spontaneous pneumothorax using air leak measurements.

    Hallifax, Rob J / Laskawiec-Szkonter, Magda / Rahman, Najib M

    Thorax

    2018  Volume 74, Issue 4, Page(s) 410–412

    Abstract: The initial treatment regime for primary spontaneous pneumothorax (PSP) is generic and non-personalised, often involving a long hospital stay waiting for air leak to cease. This prospective study of 81 patients with PSP, who required drain insertion, ... ...

    Abstract The initial treatment regime for primary spontaneous pneumothorax (PSP) is generic and non-personalised, often involving a long hospital stay waiting for air leak to cease. This prospective study of 81 patients with PSP, who required drain insertion, captured daily digital air leak measurements and assessed failure of medical management against prespecified criteria. Patients with higher air leak at day 1 or 2 had significantly longer hospital stay. If air leak was ≥100 mL/min on day 1, the adjusted OR of treatment failure was 5.2 (95% CI 1.2 to 22.6, p=0.03), demonstrating that early digital air leak measurements could potentially predict future medical treatment failure. TRIAL REGISTRATION NUMBER: ISRCTN79151659.
    MeSH term(s) Adult ; Chest Tubes ; Female ; Hospitalization ; Humans ; Length of Stay/statistics & numerical data ; Male ; Monitoring, Physiologic/methods ; Pneumothorax/diagnosis ; Pneumothorax/therapy ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2018-10-24
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 204353-1
    ISSN 1468-3296 ; 0040-6376
    ISSN (online) 1468-3296
    ISSN 0040-6376
    DOI 10.1136/thoraxjnl-2018-212116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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