Document Detail

Empyema and effusion: outcome of image-guided small-bore catheter drainage.
MedLine Citation:
PMID:  17943347     Owner:  NLM     Status:  MEDLINE    
Empyema and complicated pleural effusion represent common medical problems. Current treatment options are multiple. The purpose of this study was to access the outcome of image-guided, small-bore catheter drainage of empyema and effusion. We evaluated 93 small-bore catheters in 82 patients with pleural effusion (n = 30) or empyema (n = 52), over a 2-year period. Image guidance was with ultrasound (US; n = 56) and CT (n = 37). All patients were followed clinically, with catheter dwell times, catheter outcome, pleural fluid outcome, reinsertion rates, and need for urokinase or surgery recorded. Ninety-three small-bore chest drains (mean=10.2 Fr; range, 8.2-12.2 Fr) were inserted, with an average dwell time of 7.81 days for empyemas and 7.14 days for effusions (p > 0.05). Elective removal rates (73% empyema vs 86% effusions) and dislodgement rates (12% empyema vs 13% effusions) were similar for both groups. Eight percent of catheters became blocked and 17% necessitated reinsertion in empyemas, with no catheters blocked or requiring reinsertion in effusions (p < 0.05). Thirty-two patients (51%) required urokinase in the empyema group, versus 2 patients (6%) in the effusion group (p < 0.05). All treatment failures, requiring surgery, occurred in the empyema group (19%; n = 12; p < 0.05). In conclusion, noninfected pleural collections are adequately treated with small-bore catheters, however, empyemas have a failure rate of 19%. The threshold for using urokinase and larger-bore catheters should be low in empyema.
A N Keeling; S Leong; P M Logan; M J Lee
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Publication Detail:
Type:  Journal Article     Date:  2007-10-18
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  31     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-01-10     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-41     Citation Subset:  IM    
Department of Academic Radiology, Beaumont Hospital, Dublin 9, Ireland.
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MeSH Terms
Aged, 80 and over
Catheterization / methods*
Drainage / methods*
Empyema, Pleural / therapy*
Middle Aged
Pleural Effusion / therapy*
Radiology, Interventional / methods*
Retrospective Studies
Treatment Outcome

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