Pneumothorax: To drain or not to drain

Mohd Arif Mohd Zim
Damansara Specialist Hospital 2, Selangor, Malaysia

In cases of pneumothorax, especially moderate to large as seen in the X-ray provided, chest drainage should be the preferred approach. Early drainage offers rapid lung re-expansion, reduces the risk of progression to tension pneumothorax, and provides immediate symptomatic relief. It ensures a clear, protocol-based intervention, especially in emergency settings where delays can lead to deterioration. While conservative management may suit select stable patients, it lacks the predictability and safety net that chest tube insertion provides. Proactive drainage minimizes complications, shortens recovery in many cases, and improves overall patient safety. For these reasons, the motion strongly supports drainage in pneumothorax cases.

Gary Lee
University of Western Australia, Perth, Australia

Pneumothorax management continues to spark debate. Despite advances in clinical trials and evolving guidelines, the key question remains: when, how and why we should wait, and when we should intervene? In this session, will discuss on the latest evidence, real-world clinical scenarios, and patient-centred care, this debate will challenge conventional thinking and explore what defines best practice in pneumothorax care.