scholarly journals Challenges in Image-Guided Drainage of Infected Pleural Collections: A Review

2021 ◽  
Author(s):  
Ashu S. Bhalla ◽  
Manisha Jana ◽  
Priyanka Naranje ◽  
Swish K. Singh ◽  
Irshad Banday
Keyword(s):  
Pleural Fluid ◽  
Fibrinolytic Therapy ◽  
Early Initiation ◽  
Image Guided ◽  
Therapeutic Drugs ◽  
Pleural Fibrosis ◽  
Route Management ◽  
Vital Component ◽  
Fluid Collections ◽  
Hematogenous Route

AbstractInfected pleural fluid collections (IPFCs) commonly occur as a part of bacterial, fungal, or tubercular pneumonia or due to involvement of pleura through hematogenous route. Management requires early initiation of therapeutic drugs, as well as complete drainage of the fluid, to relieve patients’ symptoms and prevent pleural fibrosis. Image-guided drainage plays an important role in achieving these goals and improving outcomes. Intrapleural fibrinolytic therapy (IPFT) is also a vital component of the management. The concepts of image-guided drainage procedures, IPFT, and nonexpanding lung are discussed in this review.

Treatment of Complicated Pleural Fluid Collections With Image-Guided Drainage and Intracavitary Urokinase

CHEST Journal ◽  
1995 ◽  
Vol 108 (5) ◽  
pp. 1252-1259 ◽  
Author(s):  
Jeffrey S. Moulton ◽  
Robert E. Benkert ◽  
Kenneth H. Weisiger ◽  
Jodi A. Chambers
Keyword(s):  
Pleural Fluid ◽  
Image Guided ◽  
Fluid Collections

scholarly journals The use of thrombolytics in the management of complex pleural fluid collections

2017 ◽  
Vol 9 (5) ◽  
pp. 1310-1316 ◽  
Author(s):  
Jessica Heimes ◽  
Hannah Copeland ◽  
Aditya Lulla ◽  
Marjulin Duldulao ◽  
Khaled Bahjri ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Fluid Collections

scholarly journals RARE CASE OF SALMONELLA EMPYEMA IN MULTIPLE, LARGE LOCULATED PLEURAL FLUID COLLECTIONS

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A720-A721
Author(s):  
Farheen Shaikh ◽  
Shashitha Gavini ◽  
Jared Coe ◽  
Christopher Wexler
Keyword(s):  
Pleural Fluid ◽  
Rare Case ◽  
Fluid Collections

scholarly journals Medical Chest Drain Insertion – Considerations for a Pleural Service

2020 ◽  
Author(s):  
Ying-Tung Liu ◽  
Zi Wei Goh ◽  
Lutz Beckert
Keyword(s):  
Success Rate ◽  
Pleural Fluid ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Fibrinolytic Therapy ◽  
Chest Drain ◽  
Pleural Effusions ◽  
Talc Pleurodesis ◽  
Malignant Pleural Effusions ◽  
The Right

Abstract Aim: To review local chest drain insertions, the indications, use of fibrinolytics, and the success rate of talc pleurodesis in a tertiary hospital in New Zealand. Methods: This is an observational study of all patients requiring chest drain insertion in the respiratory unit in Christchurch Hospital from January 2015 to December 2016. We analysed patient characteristics, type of drain inserted, and the nature of pleural fluid. We report the success of fibrinolytic therapy for empyema and pleurodesis for malignant pleural effusions. Results: A total of 486 chest drains were inserted for 333 patients, with a median age of 69 years. The majority of patients were male (60%) and 259 drains (53.3%) were inserted on the right. The main indications for chest drain insertion were malignant pleural effusions (50.5%), non-malignant pleural fluid (33.6%) and pneumothorax (17.7%). Most drains inserted were of small caliber; they were 12 French (Fr) (62.4%), central venous catheters to drain the pleural space (14.2%), and indwelling pleural catheters (10.9%). Talc slurry pleurodesis for malignant pleural effusions was used in 40 cases with a success rate of 75%. In the 41 cases of empyema and complicated parapneumonic effusions (CPE), 29 organisms were cultured. The majority of organisms identified were Streptococcus and Staphylococcus species. Fibrinolytics were used in 26 cases (52%) of empyema and CPE. Of the 22 patients who required surgical intervention, only two had prior fibrinolytic therapy for empyema / CPE. Conclusion: Small bore catheters were used in Christchurch in keeping with international guidelines. The success rate of talc slurry pleurodesis and fibrinolytic therapy was in keeping with international experience.

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