The MRINZ played a key role in setting up and coordinating the largest randomised controlled trial of the treatment of pneumothorax (collapsed lung). This challenged the dogma of invasive management with a chest drain, showing instead that a ‘hands-off’ conservative approach not only lessens pain, but significantly reduces injury, infection and time spent in hospital, even when the lung collapse is quite large. The study took place over six years with over 300 patient in 33 hospitals across Australia and New Zealand., with the results published in the New England Journal of Medicine here.

*Medical illustration by Dr Ciléin Kearns*

“This definitive study shows that sometimes, medical intervention is not always in a patient’s best interest and that by stepping back and doing less, doctors can actually improve patient recovery” says study co-author and respiratory physician Dr Kyle Perrin from the Medical Research Institute of New Zealand (MRINZ). “We’ve demonstrated that this conservative, non-interventional approach is safe. Patients can be sent home to recover, get back to work and get on with their normal lives more efficiently and effectively, avoiding all the complications that go along with sticking a tube into the chest.”

Study co-author and lead investigator for Auckland hospital in the trial, Associate Professor Peter Jones from the University of Auckland, says this research will change medical practice for the treatment of a collapsed lung and have worldwide impact. It’s a great example of the need for research in emergency situations where many of the treatments used ‘routinely’ do not have strong evidence to support them” says Associate Professor Jones. “Studies like this are the only way to truly find whats best and safest for patients”.

The study was coordinated in New Zealand by the MRINZ and in Australia by the Centre for Clinical Research in Emergency Medicine at Royal Perth Hospital. Funding for the New Zealand arm of the study was provided by the Health Research Council of New Zealand (HRC) and the Greenlane Research and Education Fund.

Through this study, a strong network of trial centres in pleural disease has been built in Australia and New Zealand which will facilitate ongoing research.