The utility of daily therapeutic thoracentesis for the treatment of early empyema.
OBJECTIVE
To determine if therapeutic thoracentesis is as effective as early chest tube placement or no drainage procedure in the treatment of early empyema in rabbits.


METHODS
An empyema, as evidenced by gross pleural pus and a decreased pleural fluid pH and glucose level, was induced in 49 rabbits. The rabbits were divided into three groups: 16 underwent daily therapeutic thoracentesis starting at 48 h, 14 underwent chest tube placement at 48 h, and 19 served as controls.


RESULTS
The mortality rate in the therapeutic thoracentesis group (0/16) did not differ significantly from that in the chest tube group (3/14) or that in the control group (6/19). At autopsy at 10 days, the gross empyema score in the therapeutic thoracentesis group (2.1 +/- 0.3) was significantly lower (p < 0.05) than that in the chest tube group (2. 8 +/- 0.3) or the control group (3.5 +/- 0.2). The mean pleural peel score of 5.8 +/- 1.1 in the therapeutic thoracentesis group was significantly less (p < 0.05) than the score for the nonintervention control group (13.4 +/- 1.6).


CONCLUSIONS
From this study, we conclude that therapeutic thoracentesis is at least as effective as early chest tube placement for the treatment of early empyema using our rabbit model of empyema.
Sasse
S
S
Pulmonary Disease Division, Department of Veterans Affairs Medical Center, Long Beach, CA, USA.
Nguyen
T
T
Teixeira
L R
LR
Light
R
R
D000818:Animals; D004322:Drainage; D016724:Empyema, Pleural / Q000628:therapy*; D011677:Punctures; D011817:Rabbits; D016896:Treatment Outcome