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Lead
Beth Israel Deaconess Medical Center
Background: Pleural infection (empyema or complex parapneumonic effusion (CPPE)) represents one of the most common clinical diagnoses encountered in clinical practice in the United States (US) It is associated with substantial morbidity and mortality despite advances in medical diagnostic and therapeutic strategies.
Objective: Compare two standard of care treatments: TPA/DNase vs early medical Thoracoscopy
Methods: We will conduct a prospective randomized clinical trial. We plan to enroll a total of 80 patients and randomize them to either Medical Thoracoscopy group or Fibrinolytic Therapy group.
Follow-up will be daily until hospital discharge and at 6 and 12 weeks in the outpatient setting
Primary Outcome: Duration of hospital stay after intervention
Secondary Outcome: Failure rate of assigned treatment and adverse events
Potential Outcome and Benefit: Determine best strategy for treating patients with pleural infection
Age
18–any
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
Subjects \>18 years old with:
Evidence of empyema or complex parapneumonic effusion
You may not be if
Age \<18 years
Pregnancy
Inability to give informed written consent
Previous thoracic surgery or thrombolytic therapy for pleural infection
Medical thoracoscopy cannot be performed within 48 hours
Hemodynamic instability or severe hypoxemia
Non corrected coagulopathy
Homogeneously echogenic effusion on pleural ultrasonography
