Management of pleural infections.

Management of pleural infections. Expert Rev Respir Med. 2018 May 20;:1-15 Authors: Ferreiro L, Porcel JM, Bielsa S, Toubes ME, Álvarez-Dobaño JM, Valdés L Abstract INTRODUCTION: The management of infected pleural effusion is complex. Therapeutic resolution requires determining the following: appropriate antibiotic regimen, the need for pleural drainage, the optimal drainage tube size, and the need for intrapleural therapy or surgery. Areas covered: An updating of the latest advances in the management of parapneumonic pleural effusion based on the best evidence available is provided. Expert commentary: The correct management of parapneumonic pleural effusion is based on selecting an antibiotic regimen according to the origin of the pleural infection (community-acquired or nosocomial). If pleural drainage is indicated, a small-bore chest tube is appropriate. Although the administration of fibrinolytics is not required in all cases, when necessary, recombinant t-PA in combination with deoxyribonuclease is the preferred therapy. If surgery is indicated, video-assisted thoracoscopic surgery is as effective - if not superior - as open decortication. All these therapies should be complemented with appropriate nutritional support. Further clinical trials are needed to confirm whether new therapeutic strategies such as a pleural cavity saline wash are more effective in the management of this disease. PMID: 29781330 [PubMed - as su...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research