Size of traumatic pneumothorax on initial chest x-ray is independently associated with failed observation in children

When a kid has a traumatic pneumothorax, do we need to put in a chest tube right away, or can we safely monitor? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. This study tackled the question of whether the size of the pneumothorax on the first chest X-ray predicts who will fail observation. Looking at over 300 kids with traumatic pneumothorax, they found that only 13% failed observation and later needed a chest tube placed. But those who failed had a significantly larger pneumothorax. And here's the key number, a pneumothorax size of 12.5% or more on chest X-ray calculated with the Collins Volumetric. Method was the only factor that predicted failure, even after controlling for ventilation, hypotension, and hemopneumothorax. Kids with a smaller pneumothorax did just fine without a chest tube. So the takeaway is that the pneumothorax size matters. Let us know what you think in the comments below and stay tuned for more articles that you should know about.