Study design (if review, criteria of inclusion for studies)
Randomised and quasi-randomised controlled trials which compared the use of chemical pleurodesis to surgical interventions for the treatment of persistent and recurrent pneumothoraces in CF.
Participants
Children and adults diagnosed with CF as defined by two or more clinical features of CF and a documented sweat chloride greater than 60 milliequivalent per liter (mEq/L) by quantitative pilocarpine iontophoresis test or a genotype showing two well-characterized disease-causing mutations. Participants have also been diagnosed with either spontaneous persistent (if the air leak is ongoing for more than five days) or spontaneous recurrent pneumothorax (occurring more than seven days since radiographic resolution of a previous pneumothorax).
Interventions
Chemical pleurodesis
Outcome measures
Primary outcomes 1. Recurrence of pneumothorax 2. Mortality 3. Quality of life
Main results
No trials were included in this review
Authors' conclusions
Pneumothorax is a potentially life-threatening complication for people with cystic fibrosis and the management of spontaneous pneumothoraces remains a topic of considerable controversy. Medical and surgical intervention are the two main categories for the treatment of recurrent pneumothoraces in this population. However, it is disappointing that neither intervention has been assessed by randomised controlled trials. This systematic review identifies the need for a multicentre randomised controlled trial assessing both efficacy and possible adverse effects of the use of chemical pleurodesis versus surgical interventions for the treatment of persistent and recurrent pneumothoraces in people with cystic fibrosis. Due to a current lack of research in this area, while searches will still be undertaken every two years, the review will only be updated if any new evidence comes to light.