Management of pleural infections.

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.

journal_name

Expert Rev Respir Med

authors

Ferreiro L,Porcel JM,Bielsa S,Toubes ME,Álvarez-Dobaño JM,Valdés L

doi

10.1080/17476348.2018.1475234

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

521-535

issue

6

eissn

1747-6348

issn

1747-6356

journal_volume

12

pub_type

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