ERS 2020: Ambulatory vs Standard Care in Primary Spontaneous Pneumothorax

Sarfaroj Khan 


September 21, 2020


  • Ambulatory management of primary spontaneous pneumothorax (PSP) was associated with shorter hospital stay in the first 30 days compared with standard care.

  • PSP can be effectively managed in an outpatient setting using ambulatory devices in those who need intervention. 

Why this matters

  • The optimal management of PSP is not well defined and current care procedures often result in prolonged hospitalization (4-8 days).

Study design

  • RAMPP: patients with PSP (n=236) recruited from 24 hospitals in the UK were randomly assigned (1:1) to either treatment with ambulatory care (pleural vent insertion) or standard care (aspiration ± standard chest tube insertion).

  • Primary outcome was hospital stay in the first 30 days.

  • Funding: National Institute of Health Research, UK; Medical Research Council, UK.

Key results

  • At 30 days, the ambulatory treatment group had significantly shorter median hospitalization (median, 0 [interquartile range [IQR], 0-3] days) compared with the standard care group (median, 4 [IQR, 0-8] days) (P<.0001; median difference, 2 [95% CI, 1-3] days). 

  • Patients in the ambulatory group underwent fewer pleural procedures than the standard care group (21% vs 35%). 

  • Pain and breathlessness scores were comparable between both groups.

  • The incidence of serious adverse events was higher in the ambulatory treatment group than in the standard care group (12% vs 0%; P<.0001).


  • Open-label design.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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