Benefits of Early Aggressive Management of Empyema Thoracis

Bilgin, Mehmet; Akçalı, Yiğit; Oğuzkaya, Fahri

doi:10.1111/j.1445-2197.2006.03666.x

Cited by 98 publications

(77 citation statements)

References 9 publications

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“…To date, two randomised trials have compared primary VATS against conservative chest tube drainage in adult patients and neither showed any major clinical benefits, except for a slightly shorter hospital stay (mean¡SD; 8.7¡0.9 versus 12.8¡1.1 days) [105,106]. Two randomised trials in paediatric patients also failed to show significant advantages of surgery [102,107], although both of these studies suggested lower treatment costs in the fibrinolysis groups, although these were secondary analyses.…”

Section: Surgery For Empyemamentioning

confidence: 99%

Empyema thoracis: new insights into an old disease

Brims

Lansley²,

Waterer³

et al. 2010

Eur Respir Rev

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Pleural infection is a disease of historical importance and is still a modern menace, with incidences rising in adults and children, and a significant mortality in adults. Basic research is hampered by limitations with in vivo models, and the bacteriology of empyema is complex. The role of thoracic ultrasound in guiding investigation and drainage of empyema is clear. Prompt treatment with appropriate systemic antibiotics and chest tube drainage are the key; in cases of failure of these measures, thoracic surgery is of proven efficacy in the treatment of this age-old disease.

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Section: Surgery For Empyemamentioning

confidence: 99%

Empyema thoracis: new insights into an old disease

Brims

Lansley²,

Waterer³

et al. 2010

Eur Respir Rev

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“…Although surgery has been advocated as initial treatment for all patients with pleural infection [19][20][21] , evidence to support the unselected use of surgery in all patients is lacking. Two moderate sized paediatric clinical trials showed no clinical benefit and greater cost from this approach 12,22 and two small adult randomised trials did not use robust outcome methodologies 23,24 . Surgical thoracic procedures are associated with anaesthetic and perioperative risks 25 , and thoracotomy causes substantial post-operative pain 26 up to 3 years after operation 27 .…”

Section: Introductionmentioning

confidence: 99%

A Clinical Score (RAPID) to Identify Those at Risk for Poor Outcome at Presentation in Patients With Pleural Infection

Rahman

Kahan

Miller

et al. 2014

Chest

146

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“…Hence, the fibrinolytic agent can be applied for improvement of drainage. A series studies also considered that the streptokinase or urokinase used in the pleural cavity can reduce hospital stay, prognosis improvement (9,(47)(48)(49)(50)(51) and prevent catastrophic hazards (4,50,52,53). However, the largest random and controlled clinical study considers that streptokinase application in the pleural cavity has failed to improve hospital stay, death rate and others, to date (22) and a researcher also considers that the fibrinolytic agent has failed to reduce fatality rate (54).…”

Section: Intrapleural Cavity Injectionmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication.According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future.

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Benefits of Early Aggressive Management of Empyema Thoracis

Abstract: Video-assisted thoracoscopic evacuation and chest tube insertion in situ is a new therapeutic approach for pleural empyema that shortens hospital stay and reduces the necessity of open decortication.

Cited by 98 publications

References 9 publications

Empyema thoracis: new insights into an old disease

Empyema thoracis: new insights into an old disease

A Clinical Score (RAPID) to Identify Those at Risk for Poor Outcome at Presentation in Patients With Pleural Infection

Infectious pleural effusion status and treatment progress

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