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Who is at risk for tPA/DNase treatment failure in empyema?-protocol to identify key predictors for early surgical intervention from a retrospective study.
J Thorac Dis
December 2024
Critical Care Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA.
Background: Empyema, characterized by the accumulation of pus in the pleural cavity, poses significant treatment challenges. While intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy is effective for many patients, a substantial proportion require surgical intervention, such as video-assisted thoracoscopic surgery (VATS), following treatment failure. Identifying tPA/DNase treatment failure-associated predictors is crucial for optimizing patient management and improving outcomes.
View Article and Find Full Text PDFMedical thoracoscopy combined with intrapleural injection of urokinase for treatment of pleural infection-a multicenter, prospective, randomized controlled study: study protocol.
Respir Res
January 2025
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Pleural diseases is a common respiratory disorder, mainly characterized as pleural effusion and patients with pleural effusion caused by pneumonia and empyema constituted 29% of the cohort, which suggests pleural infection as the predominant etiology of pleural effusion in China. Medical thoracoscopy (MT) combined with intrapleural injection of Urokinase holds significant therapeutic value for patients with early to moderate-stage empyema. However, there remains a lack of high-quality evidence regarding the efficacy and safety of combining MT with intrapleural injection of Urokinase administration in patients with pleural infections.
View Article and Find Full Text PDFSurgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula.
J Cardiothorac Surg
January 2025
Department of Thoracic and Vascular Surgery, and Lung Transplantation, Marie-Lannelongue Hospital, Le Plessis-Robinson, France.
Background: Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized.
Case Presentation: We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life.
Evaluating the feasibility, sensitivity, and specificity of next-generation molecular methods for pleural infection diagnosis.
Microbiol Spectr
January 2025
Sunshine Coast Health Institute, Birtinya, Queensland, Australia.
Pleural infections are common and associated with substantial healthcare costs, morbidity, and mortality. Accurate diagnosis remains challenging due to low culture positivity rates, frequent polymicrobial involvement, and non-specific diagnostic biomarkers. Here, we undertook a prospective study examining the feasibility and performance of molecular methods for diagnosing suspected pleural infection.
View Article and Find Full Text PDFAddressing the need for better management of pleural infections in low- to middle-income countries.
Expert Rev Respir Med
January 2025
Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
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