In secondary spontaneous pneumothorax (SSP), the first step is chest drain insertion and admission. When drainage does not achieve resolution — leaving a persistent air leak — a next-line protocol applies for adult patients who are not surgical candidates.
The initial intervention — chest drain insertion and admission — aims to achieve complete pneumothorax resolution, confirmed on chest X-ray with no residual air leak. When this goal is not met, escalation to the next management step is warranted.
For adults with SSP and a persistent air leak who are not fit for surgery, an autologous blood patch procedure may be considered. Full eligibility criteria, decision guidance, and procedural details are available in the complete protocol.
Resolution of air leak.