A 42-year-old woman with lymphangioleiomyomatosis develops a large right pneumothorax requiring chest drain insertion on ICU. Despite correct drain pl...

Question

A 42-year-old woman with lymphangioleiomyomatosis develops a large right pneumothorax requiring chest drain insertion on ICU. Despite correct drain placement confirmed by imaging, there is a persistent large air leak and the lung fails to re-expand after 48 hours. What is the most appropriate next step?

Accepted Answer

Apply suction (-10 to -20 cmH2O) to the existing chest drain

Answer

Insert a second intercostal drain anteriorly

Answer

Remove the drain and observe conservatively

Answer

Commence high-frequency oscillatory ventilation

Answer

Administer prophylactic antibiotics and wait 7 days

uk-fficm MCQ (SBA): Persistent Pneumothorax