Abstract
Background Spontaneous pneumothorax should be classified as primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP) because treatment strategies may differ depending on underlying lung conditions and clinical course. The pulmonary dysfunction can lead to changes in end-tidal carbon dioxide (ETCO2). The aim of this study was to investigate the difference in ETCO2 between PSP and SSP. Methods This retrospective observational study included adult patients diagnosed with spontaneous pneumothorax in the emergency room from April 2019 to September 2020. We divided patients into PSP and SSP groups and compared ETCO2 variables between the two groups. Results There were 33 (66%) patients in the PSP group and 17 (34%) patients in the SSP group. Initial ETCO2 was lower in the SSP group than in the PSP group (30 (23–33) vs. 35 (33–38) mmHg, p=0.002). Multivariate analysis revealed that respiratory gas associated with SSP was initial ETCO2 (OR: 0.824; 95% CI: 0.697–0.974, p=0.023). The optimal cutoff for initial ETCO2 to detection of SSP was 32 mmHg (area under curve, 0.754), with 76.5% sensitivity and 72.7% specificity. Conclusion ETCO2 monitoring is a reliable noninvasive indicator of differentiating between PSP and SSP. Initial ETCO2 lower than 32 mmHg is a predictor of SSP.
Highlights
Spontaneous pneumothorax (SP) without external factor is traditionally classified as primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP) based on the absence or presence of associated underlying lung conditions
A total of 66 patients were diagnosed as spontaneous pneumothorax in ED from April 2019 to September 2020
50 patients were enrolled for the analysis. ey were divided into two groups: 33 (66%) in the PSP group and 17 (34%) in the SSP group
Summary
Spontaneous pneumothorax (SP) without external factor is traditionally classified as primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP) based on the absence or presence of associated underlying lung conditions. [1] Regarding management strategies, characteristics of pneumothorax itself, and the underlying lung disease associated with SPP should be considered. The ETCO2 level is 35–40 mmHg. ETCO2 is correlated with partial pressure of carbon dioxide in arterial blood (PaCO2). Spontaneous pneumothorax should be classified as primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP) because treatment strategies may differ depending on underlying lung conditions and clinical course. E pulmonary dysfunction can lead to changes in end-tidal carbon dioxide (ETCO2). Initial ETCO2 was lower in the SSP group than in the PSP group (30 (23–33) vs 35 (33–38) mmHg, p 0.002). Initial ETCO2 lower than 32 mmHg is a predictor of SSP
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