166 The prevalence and aetiology of pleural effusions and empyema in patients attending a regional adult CF centre

Abstract

Objectives: Pneumothorax in CF is associated with poor prognosis, increased hospitalisation and deteriorating lung function. Persistent air leaks and delayed lung expansion lead to slow resolution. We aimed to improve care using ambulatory suction. Methods: 3 adults with CF were treated with an ambulatory suction device (ThopazTM system) used with intercostal drainage. Results: 1. Surgical emphysema and persistent air leak in a 22 year old male with pneumothorax led to change from a small bore to large bore drain with suction. Lack of ambulation and chest pain limited airway clearance. Drain blockage required repeated flushes. Thopaz system improved airway clearance, reduced pain and measured air leak. Self flushing mechanism reduced drain blockage, allowing resolution in 10 days. 2. 19 year old male with end stage lung disease developed a pneumothorax. Minimal resolution and persistent air leak were seen despite a 12F drain. Patient declined large bore chest drain and/or suction due to limited ambulation. Surgical options were considered too high risk. Use of Thopaz system allowed suction use, maintained ambulation and measured air leak. Successful resolution occurred in 7 days. 3. A 22 year old female presented with ipsiliateral pneumothorax following failed pleurodesis with persistent air leak and severe dyspnoea. End stage disease and thrombocytopenia prevented surgical treatment. Pneumothorax resolved with Thopaz system aiding symptom palliation. Conclusion: Pneumothorax in CF is complicated by limited surgical options and slow resolution. Use of an ambulatory suction device improves outcomes and reduces patient morbidity. We aim to trial this device in future patients.