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CardioVascular and Interventional Radiology

, Volume 31, Issue 1, pp 135–141 | Cite as

Empyema and Effusion: Outcome of Image-Guided Small-Bore Catheter Drainage

  • A. N. Keeling
  • S. Leong
  • P. M. Logan
  • M. J. Lee
Clinical Investigation

Abstract

Empyema and complicated pleural effusion represent common medical problems. Current treatment options are multiple. The purpose of this study was to access the outcome of image-guided, small-bore catheter drainage of empyema and effusion. We evaluated 93 small-bore catheters in 82 patients with pleural effusion (= 30) or empyema (= 52), over a 2-year period. Image guidance was with ultrasound (US; = 56) and CT (= 37). All patients were followed clinically, with catheter dwell times, catheter outcome, pleural fluid outcome, reinsertion rates, and need for urokinase or surgery recorded. Ninety-three small-bore chest drains (mean=10.2 Fr; range, 8.2–12.2 Fr) were inserted, with an average dwell time of 7.81 days for empyemas and 7.14 days for effusions (> 0.05). Elective removal rates (73% empyema vs 86% effusions) and dislodgement rates (12% empyema vs 13% effusions) were similar for both groups. Eight percent of catheters became blocked and 17% necessitated reinsertion in empyemas, with no catheters blocked or requiring reinsertion in effusions (< 0.05). Thirty-two patients (51%) required urokinase in the empyema group, versus 2 patients (6%) in the effusion group (< 0.05). All treatment failures, requiring surgery, occurred in the empyema group (19%; = 12; < 0.05). In conclusion, noninfected pleural collections are adequately treated with small-bore catheters, however, empyemas have a failure rate of 19%. The threshold for using urokinase and larger-bore catheters should be low in empyema.

Keywords

Small-bore chest drain Empyema Pleural effusion Image-guided chest catheter 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • A. N. Keeling
    • 1
  • S. Leong
    • 1
  • P. M. Logan
    • 1
  • M. J. Lee
    • 1
  1. 1.Department of Academic RadiologyBeaumont HospitalDublin 9Ireland

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