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Internal medicine journal · Aug 2002
ReviewManagement of complicated parapneumonic effusions and thoracic empyema.
- R J Cameron.
- Intensive Care Unit, Gosford Hospital, New South Wales, Australia. rcameron@doh.health.nsw.gov.au
- Intern Med J. 2002 Aug 1;32(8):408-14.
AbstractThe optimal management of loculated parapneumonic effusions and empyema includes breakdown of adhesions to effect drainage of infected pleural fluid. The use of fibrinolytics intrapleurally appears to enhance intercostal tube drainage, reducing the requirement for subsequent surgical mechanical debridement. This article discusses the evidence for intrapleural fibrinolytics, their good safety profile and the practicalities of dose and administration. It also reviews early surgical intervention, which may be indicated for medical treatment failure and, some would argue, as a suitable alternative to other medical interventions.
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