Chemical pleurodesis versus surgical intervention for persistent and recurrent pneumothoraces in cystic fibrosis

Department of Pediatric Respirology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2009; 12(2):CD007481. DOI: 10.1002/14651858.CD007481.pub2
Source: PubMed


Cystic fibrosis is an inherited disease which irreversibly damages the lungs. People with cystic fibrosis are prone to getting a pneumothorax. A pneumothorax is defined as the presence of air in the space between the two linings of the lungs. It can potentially kill people with cystic fibrosis because of the added stress on the heart and lungs. It can be treated by surgical and non-surgical interventions. However, although these treatments are generally effective, they are far from perfect. Certain treatments work in some people but not others. Also, the treatments do have side effects and can be dangerous for people with cystic fibrosis. Currently, physicians do not know the safest and most effective way of treating pneumothorax in people with cystic fibrosis. We did not find any randomised controlled trials that compared the surgical and non-surgical treatments for pneumothorax in people with cystic fibrosis. Therefore, more research is needed in this field. Future studies should compare the safety and efficacy of surgical and non-surgical interventions for pneumothorax in people with cystic fibrosis. There is currently no research being undertaken in this area. We will continue to search for evidence, but will not be updating the review until we find new evidence.

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    • "Looking at the data in the literature, there is a lack of randomized controlled trials comparing the efficacy and safety of the different techniques employed for the treatment of pneumothorax in CF patients [13]. Moreover, the number of scientific contributions on this topic has been decreasing in recent years; most studies refer to experiences that have occurred a few decades ago; very few papers have been published in the last 10 years. "
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    ABSTRACT: Indications for thoracic surgery in patients with cystic fibrosis (CF) are principally represented by pleural diseases including pneumothorax, pleural effusion, and empyema and by parenchymal lung diseases including bronchiectasis, hemoptysis, and pulmonary abscess. Moreover, lung transplantation has proved a viable therapeutic option for progressive respiratory failure due to end-stage CF. Main surgical experiences in this setting are reviewed and discussed.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 05/2011; 39(5):716-25. DOI:10.1016/j.ejcts.2010.07.024 · 3.30 Impact Factor
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    ABSTRACT: RATIONALE: Cystic fibrosis is a recessive genetic disease characterized by dehydration of the airway surface liquid and impaired mucociliary clearance. As a result, individuals with the disease have difficulty clearing pathogens from the lung and experience chronic pulmonary infections and inflammation. There may be intermittent pulmonary exacerbations, or acute worsening of infection and obstruction, which require more intensive therapies. Hemoptysis and pneumothorax are complications commonly reported in patients with cystic fibrosis. OBJECTIVES: This document presents the CF Foundation√Ęs Pulmonary Therapies Committee recommendations for the treatment of hemoptysis and pneumothorax. METHODS: The committee recognized that insufficient data exist to develop evidence-based recommendations and so used the Delphi technique to formalize an expert panel√Ęs consensus process and develop explicitly care recommendations. CONCLUSIONS: These recommendations for the management of the CF patient with hemoptysis and pneumothorax are designed for general use in most individuals but should be adapted to meet specific needs as determined by the individuals, their families, and their health care providers. It is hoped that the guidelines provided in this manuscript will facilitate the appropriate application of these treatments to improve and extend the lives of all individuals with cystic fibrosis.
    American Journal of Respiratory and Critical Care Medicine 03/2010; DOI:10.1164/rccm.201002-0157OC · 13.00 Impact Factor
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