From the Guidelines
Patients with a resolved pneumothorax confirmed radiologically should not fly until at least 7 days after the X-ray demonstrates full resolution. This recommendation is based on the most recent guidelines from the British Thoracic Society 1, which emphasize the importance of waiting for complete radiological resolution before flying to minimize the risk of recurrence. The guidelines suggest that patients with a persistent closed pneumothorax should not travel on commercial flights until complete radiological resolution is achieved.
Key considerations for flying after a spontaneous pneumothorax include:
- Waiting for complete radiological resolution, confirmed by a chest X-ray (CXR)
- Avoiding air travel for at least 7 days after radiological resolution 1
- Obtaining clearance from a treating physician before flying
- Being aware of symptoms that might indicate a recurrence, such as sudden chest pain or shortness of breath
It is also important to note that activities that involve pressure changes, like scuba diving, should be avoided permanently unless a very secure definitive prevention strategy has been performed, such as surgical pleurectomy 1. Additionally, smoking cessation should be advised to reduce the risk of recurrence 1. By following these guidelines, patients can minimize their risk of complications and ensure a safe recovery after a spontaneous pneumothorax.
From the Research
Recommended Time Interval for Flying After Spontaneous Pneumothorax
The recommended time interval for flying after a spontaneous pneumothorax is a topic of ongoing debate and research.
- A 2024 study published in Aerospace Medicine and Human Performance suggests that air travel with a known pneumothorax is likely safe and can be undertaken much sooner than current guidelines advise 2.
- A 2018 study in The Journal of Trauma and Acute Care Surgery found that air travel after tube thoracostomy removal appears safe for both mechanically ventilated and nonventilated patients after a 72-hour period of observation 3.
- However, other studies recommend waiting at least 2 weeks after radiographic resolution of the pneumothorax before flying 4, 5.
- A case report of an F/A-18 aviator who successfully returned to flight after an in-flight spontaneous pneumothorax suggests that individual factors, such as the presence of apical blebs and the results of pulmonary function testing, may influence the decision to return to flight 6.
Key Findings
- The majority of studies suggest that the risk of recurrence or complications during air travel is low if the pneumothorax has resolved radiographically and the patient has been observed for a period of time 2, 3, 5.
- The optimal time interval for flying after spontaneous pneumothorax is not well established and may depend on individual factors, such as the size and location of the pneumothorax, the presence of underlying lung disease, and the results of pulmonary function testing 4, 6.
- Further research is needed to determine the safest and most effective approach to managing patients with spontaneous pneumothorax who wish to fly 2, 4.