Intrapleural Therapy in Empyema Thoracis: A Contemporary Solution to an Age-Old Problem?

摘要

Infection within the pleural space has posed a management dilemma for physicians since the time of Hippocrates. Despite advances in medical treatment for pneumonia, the incidence of both complicated parapneumonic effusion and empyema is increasing in both the United States and the United Kingdom.u The impact of the problem is significant; with up to one-third of patients progressing to surgical decorti-cation and drainage and overall mortality ranging from 10%-20%. Complete drainage of the infection is the key management principle. Systemic antibiotic therapy and drainage of the pleural space via tube thoracostomy constitute first-line management, with surgical drainage reserved for those with complicated effusions, development of a pleural "peel or rind," or uncontrolled pleural sepsis.