Management of Empyema
Pleural effusions are commonly associated with pneumonia; however, progression to empyema can occur. The fluid must be sampled if there is concern for empyema. A tube thoracostomy should be placed to drain the fluid; if the collection persists despite drainage, fibrinolytics can be instilled through the tube, or, in certain circumstances, the patient may proceed directly to surgical intervention.
KeywordsParapneumonic effusion Empyema Thoracentesis Fibrinolytic Decortication VATS
- 3.Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, Peckham D, Davies CW, Ali N, Kinnear W, Bentley A, Kahan BC, Wrightson JM, Davies HE, Hooper CE, Lee YC, Hedley EL, Crosthwaite N, Choo L, Helm EJ, Gleeson FV, Nunn AJ, Davies RJ. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011;365(6):518–26. https://doi.org/10.1056/NEJMoa1012740.CrossRefPubMedGoogle Scholar