28 June 2012
Treatment of complicated parapneumonic pleural effusion and pleural parapneumonic empyemaPedro Rodríguez SuárezABCDEF, Jorge Freixinet GilartABCDEG, José María Hernández PérezBEF, Mohamed Hussein SerhalB, Antonio López ArtalejoB
Med Sci Monit 2012; 18(7): CR443-449
Background: We performed this observational prospective study to evaluate the results of the application of a diagnostic and therapeutic algorithm for complicated parapneumonic pleural effusion (CPPE) and pleural parapneumonic empyema (PPE).
Material/Methods: From 2001 to 2007, 210 patients with CPPE and PPE were confirmed through thoracocentesis and treated with pleural drainage tubes (PD), fibrinolytic treatment or surgical intervention (videothoracoscopy and posterolateral thoracotomy). Patients were divided into 3 groups: I (PD); II (PD and fibrinolytic treatment); IIIa (surgery after PD and fibrinolysis), and IIIb (direct surgery). The statistical study was done by variance analysis (ANOVA), χ2 and Fisher exact test.
Results: The presence of alcohol or drug consumption, smoking and chronic obstructive pulmonary disease (COPD) were strongly associated with a great necessity for surgical treatment. The IIIa group was associated with increased drainage time, length of stay and complications. No mortality was observed. The selective use of PD and intrapleural fibrinolysis makes surgery unnecessary in more than 75% of cases.
Conclusions: The selective use of PD and fibrinolysis avoids surgery in more than 75% of cases. However, patients who require surgery have more complications, longer hospital stay, and more days on PD and they are more likely to require admittance to the Intensive Care Unit.
Keywords: Pneumonia - therapy, Pleural Effusion - therapy, Pleura - pathology, Empyema, Pleural - therapy, Radiography, Thoracic, Tomography, X-Ray Computed
01 March 2023 : EditorialEditorial: Global Surveillance of Highly Pathogenic Avian Influenza Viruses in Poultry, Wild Birds, and Mammals to Prevent a Human Influenza Pandemic
Med Sci Monit 2023; 29:e939968
03 March 2023 : Database AnalysisReinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Po...
Med Sci Monit In Press; DOI: 10.12659/MSM.939452
09 February 2023 : Clinical ResearchEvaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...
Med Sci Monit 2023; 29:e938892
19 January 2023 : Clinical ResearchDetermining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...
Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical ResearchEffect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...
Med Sci Monit 2022; 28:e938926
21 Mar 2023 : Clinical ResearchEfficacy of Direct Anterior Approach Versus Posterior Lateral Approach for Total Hip Replacement in Patient...
Med Sci Monit In Press; DOI: 10.12659/MSM.939682
21 Mar 2023 : Clinical ResearchIntraoperative Hypotension and Its Association with Postoperative Acute Kidney Injury in Patients Undergoin...
Med Sci Monit In Press; DOI: 10.12659/MSM.938945
20 Mar 2023 : Clinical ResearchManagement of Unstable C1 Fractures Involving the Lateral Mass: Posterior C1-C2 Screw-Rod Fixation and Fusion
Med Sci Monit In Press; DOI: 10.12659/MSM.938600
17 Mar 2023 : Clinical ResearchRelationship Between Autonomic Nervous System Activity and Axial Length in Children
Med Sci Monit In Press; DOI: 10.12659/MSM.939451
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...
Med Sci Monit 2022; 28:e935952