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pleural empyema guidelines

Vikas Koppurapu, Nikhil Meena
A complex para-pneumonic effusion is a descriptive term for exudative effusions, which complicate or are likely to complicate the anatomy of the pleural space after pneumonia. We performed an online search was performed using the resources PubMed and Google Scholar to provide an update on the management of such effusions based on review of published literature. Search terms including pleural effusion (PE), parapneumonic effusion, and empyema were used. Relevant studies were identified and original articles were studied, compared and summarized...
July 2017: Journal of Thoracic Disease
Nobuhiro Asai, Hiroyuki Suematsu, Mao Hagihara, Naoya Nishiyama, Hideo Kato, Daisuke Sakanashi, Yusuke Koizumi, Yuka Yamagishi, Hiroshige Mikamo
OBJECTS: Changes in patients' background and life environment could contribute to increase healthcare-associated (HCA) empyema. There are no guidelines and statements for HCA empyema. METHODS: We retrospectively reviewed all patients with empyema who were admitted to the Aichi Medical University Hospital, Japan between 2008 and 2015. We evaluated patients' characteristics, microbial profiles, treatment and outcomes, and analyzed prognostic factors for 90-day mortality...
October 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Kibwe Alphonse Simbi, Valentin Kazadi, Louis-Marie Aissi, François Mbahewaka Katsuva, Numbi Oscar Luboya, Léon Tshilolo, Vincenzo Zanardo
Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo...
June 23, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Rana Khazar Al-Zoubi, Mouhanna Abu Ghanimeh, Ashraf Gohar, Gary A Salzman, Osama Yousef
Hepatic Hydrothorax (HH) is defined as a pleural effusion greater than 500 ml in association with cirrhosis and portal hypertension. It is an uncommon complication of cirrhosis, most frequently seen in association with decompensated liver disease. The development of HH remains incompletely understood and involves a complex pathophysiological process with the most acceptable explanation being the passage of the ascetic fluid through small diaphragmatic defects. Given the limited capacity of the pleural space, even the modest pleural effusion can result in significant respiratory symptoms...
October 2016: Hospital Practice (Minneapolis)
Dragan Subotic, Piotr Yablonskiy, Giorgia Sulis, Ioan Cordos, Danail Petrov, Rosella Centis, Lia D'Ambrosio, Giovanni Sotgiu, Giovanni Battista Migliori
Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included...
July 2016: Journal of Thoracic Disease
Michael H Livingston, Eyal Cohen, Lucy Giglia, David Pirrello, Niraj Mistry, Sanjay Mahant, Michael Weinstein, Bairbre Connolly, Sharifa Himidan, Andreana Bütter, J Mark Walton
BACKGROUND: Guidelines recommend that children with empyema be treated initially with chest tube insertion and intrapleural fibrinolytics. Some patients have poor outcomes with this approach, and it is unclear which factors are associated with treatment failure. METHODS: Possible risk factors were identified through a review of the literature. Treatment failure was defined as need for repeat pleural drainage and/or total length of stay greater than 2weeks. RESULTS: We retrospectively identified 314 children with empyema treated with fibrinolytics at The Hospital for Sick Children (2000-2013, n=195), Children's Hospital, London Health Sciences Centre (2009-2013, n=39), and McMaster Children's Hospital (2007-2014, n=80)...
May 2016: Journal of Pediatric Surgery
Cameron Burton, Tony Walls, Neil Price, Tamsin Glasgow, Cameron Walker, Spencer Beasley, Emma Best
AIMS: We aimed to identify the causative organisms and sensitivities in community-acquired paediatric empyema at Starship Children's Hospital and Christchurch Hospital and to determine if current antibiotic recommendations are appropriate. METHODS: Retrospective analysis was undertaken of all cases with clinical, radiological, and microbiological evidence of empyema at Starship Children's Hospital and Christchurch Hospital between June 2009 and March 2013 (3.8 years), and January 2009 and May 2014 (5...
May 29, 2015: New Zealand Medical Journal
Jean-Philippe Delpy, Pierre-Benoit Pagès, Pierre Mordant, Pierre-Emmanuel Falcoz, Pascal Thomas, Francoise Le Pimpec-Barthes, Marcel Dahan, Alain Bernard
OBJECTIVES: There are no guidelines regarding the surgical approach for spontaneous pneumothorax. It has been reported, however, that the risk of recurrence following video-assisted thoracic surgery is higher than that following open thoracotomy (OT). The objective of this study was to determine whether this higher risk of recurrence following video-assisted thoracic surgery could be attributable to differences in intraoperative parenchymal resection and the pleurodesis technique. METHODS: Data for 7647 patients operated on for primary or secondary spontaneous pneumothorax between 1 January 2005 and 31 December 2012 were extracted from Epithor®, the French national database...
March 2016: European Journal of Cardio-thoracic Surgery
D Moreno-Pérez, A Andrés Martín, A Tagarro García, A Escribano Montaner, J Figuerola Mulet, J J García García, A Moreno-Galdó, C Rodrigo Gonzalo de Lliria, J Saavedra Lozano
The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence...
September 2015: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Niral Patel, Andrew Worden, Rajul Patel, Javier Diaz-Mendoza, Lisa Stagner
Bronchology/Interventional Student/Resident Case Report Posters ISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Endobronchial valves (EBV) were marketed for use in severe emphysematous COPD. However, they have demonstrated efficacy in managing persistent Bronchopleural Fistulas (Pneumothoraces). In 2008, the FDA approved the use of the IBV Valve System via the Humanitarian Device Exemption Program. There is still limited literature detailing the use of these valves in treating persistent air leaks, few involving thoracic infections, and none involving fungal infections...
October 1, 2014: Chest
Meral Ekim, Hasan Ekim
OBJECTIVES: Purulent pericarditis is a collection of purulent effusion in the pericardial space. It has become a rare entity with the increased availability and use of antibiotics. In contrast to pleural empyema, there are few data regarding the biochemical parameters of purulent pericardial effusion to aid diagnosis. Therefore, in this study, we have evaluated the diagnostic utility of biochemical tests in patients with purulent pericarditis. METHODS: Between September 2004 and September 2012, we treated fifteen children with purulent pericarditis and tamponade...
July 2014: Pakistan Journal of Medical Sciences Quarterly
M Anderson, M Fitzgerald, K Martin, M Santamaria, S Arendse, G O'Reilly, de V Smit, U Orda, S Marasco
BACKGROUND: Intercostal catheter (ICC) insertion is the standard pleural decompression and drainage technique for blunt and penetrating traumatic injury. Potentially high complication rates are associated with the procedure, with the literature quoting over 20% in some cases (1-4). Empyema in particular is a serious complication. Risk adverse industries such as the airline industry and military services regularly employ checklists to standardise performance and decrease human errors. The use of checklists in medical practice is exemplified by introduction of the WHO Surgical Safety checklist...
January 2015: Injury
Thorsten Janisch, Ullrich Siekmann, Rüdger Kopp
Iatrogenic pulmonary barotrauma and cerebral arterial gas embolism (CAGE) may complicate a variety of medical procedures, such as certain types of surgery, drug administration through thoracic drainage, pneumoperitoneum, cystoscopy, bronchoscopy, etc. Hyperbaric oxygen treatment following the guidelines for CAGE in diving is the treatment of choice. Pleural streptokinase instillation is a common treatment for parapneumonic pleural effusion and may lead to CAGE. We present such a complication in a 79-year-old woman with a left-sided empyema...
December 2013: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Michelle M Kelly, Kristin A Shadman, M Bruce Edmonson
BACKGROUND: Recently published practice guidelines continue to reflect uncertainty about the comparative effectiveness of various treatments for empyema in children. We describe treatment trends and outcomes in pediatric empyema using the most current nationally representative data. METHODS: Using survey methods and Kids' Inpatient Databases from 1997 to 2009, we evaluated hospital stays in children 0-18 years of age. We used 2009 data to compare transfer-out rates and lengths of stay across various types of treatment, after adjusting for patient and hospital factors...
May 2014: Pediatric Infectious Disease Journal
Adrian T Billeter, Devin Druen, Glen A Franklin, Jason W Smith, William Wrightson, J David Richardson
PURPOSE: Trauma patients frequently have serious chest injuries. Retained hemothoraces and persistent pneumothoraces are among the most frequent complications of chest injuries which may lead to major, long-term morbidity and mortality if these complications are not recognized and treated appropriately. Video-assisted thoracoscopy (VATS) is a well-established technique in surgical practice. The usefulness of VATS for treatment of complications after chest trauma has been demonstrated by several authors...
April 2013: Langenbeck's Archives of Surgery
Kamran Mahmood, Momen M Wahidi
Although chest tube placement is one of the most common procedures in managing patients with pleural disease, it is not clear what size and type of chest tube is indicated for various conditions. Chest tubes can be divided into small- (≤14 French [Fr]) and large-bore (>14 Fr) and can be placed by blunt dissection, guidewire (Seldinger), or trocar guidance. Recently a trend has been seen toward using smaller chest tubes for most indications, given their relative ease and patient comfort. This article summarizes the rationale for using different chest tubes depending on the clinical scenario...
March 2013: Clinics in Chest Medicine
Rahul Bhatnagar, Nick A Maskell
The incidence of pleural infection seems to be increasing worldwide. Despite continued advances in the management of this condition, morbidity and mortality have essentially remained static over the past decade. This article summarizes the current evidence and opinions on the epidemiology, etiology, and management of complicated pleural effusions caused by infection, including empyema. Although many parallels may be drawn between children and adults in such cases, most trials, guidelines, and series regard pediatric patient groups and those more than 18 years of age as separate entities...
March 2013: Clinics in Chest Medicine
Forrest O Moore, Therese M Duane, Charles K C Hu, Adam D Fox, Nathaniel McQuay, Michael L Lieber, John J Como, Elliott R Haut, Andrew J Kerwin, Oscar D Guillamondegui, J Bracken Burns
BACKGROUND: Antibiotic use in injured patients requiring tube thoracostomy (TT) to reduce the incidence of empyema and pneumonia remains a controversial practice. In 1998, the Eastern Association for the Surgery of Trauma (EAST) developed and published practice management guidelines for the use of presumptive antibiotics in TT for patients who sustained a traumatic hemopneumothorax. The Practice Management Guidelines Committee of EAST has updated the 1998 guidelines to reflect current literature and practice...
November 2012: Journal of Trauma and Acute Care Surgery
Andrew Rosenstengel
Pleural infection is a common and increasing clinical problem in thoracic medicine, resulting in significant morbidity and mortality. In recent years there has been a marked increase in interests and publications relating to evolving interventions and management options for pleural infection and empyema. Recently published research data as well as guidelines have suggested better approaches of radiological assessment, updated management algorithms for pleural infection, intrapleural adjunct therapies and re-examined the roles of biomarkers, pleural drainage techniques, and the role of surgery...
April 1, 2012: Journal of Thoracic Disease
Alaeldin H Ahmed, Tariq E Yacoub
Empyema thoracis causes high mortality, and its incidence is increasing in both children and adults. Parapneumonic effusions (PPEs) develop in about one-half of patients hospitalized with pneumonia, and their presence increases mortality by about four-fold. PPEs can be divided into simple PPEs, complicated PPEs, and frank empyema. Two guideline statements on the management of PPEs in adults have been published by the British Thoracic Society (BTS) and the American College of Chest Physicians; a third guideline statement published by the BTS focused on management of PPEs in children...
2010: Clinical Pharmacology: Advances and Applications
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