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- W2974373641 endingPage "374" @default.
- W2974373641 startingPage "361" @default.
- W2974373641 abstract "Infection of the pleural space is an ancient and common clinical problem, the incidence which is on the rise. Advances in therapy now present clinicians of varying disciplines with an array of therapeutic options ranging from thoracentesis and chest tube drainage (with or without intrapleural fibrinolytic therapies) to video-assisted thoracic surgery (VATS) or thoracotomy. A framework is provided to guide decision making, which involves weighing multiple factors (clinical history and presentation, imaging characteristics, comorbidities); multidisciplinary collaboration and active management are needed as the clinical course over a few days determines subsequent refinement. The initial choice of antibiotics depends on whether the empyema is community-acquired or nosocomial, and clinicians must recognize that culture results often do not reflect the full disease process. Antibiotics alone are rarely successful and can be justified only in specific circumstances. Early drainage with or without intrapleural fibrinolytics is usually required. This is successful in most patients; however, when surgical decortication is needed, clear benefit and low physiologic impact are more likely with early intervention, expeditious escalation of interventions, and care at a center experienced with VATS." @default.
- W2974373641 created "2019-09-26" @default.
- W2974373641 creator A5015273934 @default.
- W2974373641 creator A5019635887 @default.
- W2974373641 creator A5067357787 @default.
- W2974373641 date "2019-06-01" @default.
- W2974373641 modified "2023-10-09" @default.
- W2974373641 title "Medical and Surgical Management of Empyema" @default.
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