Document Detail


Transthoracic ultrasonography in predicting the outcome of small-bore catheter drainage in empyemas or complicated parapneumonic effusions.
MedLine Citation:
PMID:  19616366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thoracic sonography has been advocated as being complementary to small-bore catheter drainage in pleural effusions. However, it is not known whether the initial sonographic appearances of empyemas or complicated parapneumonic effusions (CPPEs) can predict the outcomes of small-bore catheter drainage for these pleural insults. This retrospective study investigated the outcomes of patients who had been diagnosed with empyema and CPPE and had received ultrasound-guided small-bore catheter (size from 12F to 16F) drainage in a tertiary university hospital from September 2005 to August 2007. Patients were excluded when empyemas or CPPEs were traumatic, they were less than 18 years old or their charts were incomplete. We evaluated 141 small-bore catheters in 70 patients with empyemas and 71 patients with CPPEs over a two-year period. The mean age was 58+/-15 y and the male gender was more frequent (112 men, 79%). The overall successful rate of small-bore catheter drainage in empyemas or CPPEs was 63% (89/141). The sonographic appearances of these empyemas or CPPEs exhibited a complex septated pattern in 57% (81/141) of patients and a complex nonseptated pattern in 43% (60/141) of patients. The success rate in a complex nonseptated sonographic pattern was significantly higher than in a complex septated sonographic pattern (48/60, 80% vs. 41/81, 51%, respectively; p=0.001). Moreover, patients with complex septated sonographic patterns also had higher intensive care unit admission rates compared with nonseptated sonographic patterns (22/81, 27%, vs. 8/60, 13%, respectively; p=0.0047), as well as infection-related mortality rates (17/81, 21% vs. 4/60, 7%, respectively; p=0.018). The appearance of sonographic septation is a useful sign to help predict the outcome of small-bore catheter drainage in cases of empyemas or CPPEs. Patients with a complex septated sonographic pattern have a poorer prognosis for a successful outcome, higher ICU admission rate and a higher mortality rate.
Authors:
Chia-Hung Chen; Wei Chen; Hung-Jen Chen; Yang-Ho Yu; Yu-Chao Lin; Chih-Yen Tu; Wu-Huei Hsu
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Publication Detail:
Type:  Journal Article     Date:  2009-07-17
Journal Detail:
Title:  Ultrasound in medicine & biology     Volume:  35     ISSN:  1879-291X     ISO Abbreviation:  Ultrasound Med Biol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-25     Completed Date:  2009-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0410553     Medline TA:  Ultrasound Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1468-74     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacteria / isolation & purification
Catheterization, Peripheral / adverse effects,  instrumentation,  methods
Chest Tubes
Drainage / adverse effects,  instrumentation,  methods
Empyema, Pleural / microbiology,  therapy,  ultrasonography*
Female
Humans
Male
Middle Aged
Pleural Effusion / microbiology,  therapy,  ultrasonography*
Prognosis
Retrospective Studies
Treatment Outcome
Ultrasonography, Interventional / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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