tag:blogger.com,1999:blog-12660458.post111808248764311095..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: Follow-up to pleural diseaseUnknownnoreply@blogger.comBlogger3125tag:blogger.com,1999:blog-12660458.post-1118176340924742002005-06-07T16:32:00.000-04:002005-06-07T16:32:00.000-04:00I think the perc drainage approach may be catching...I think the perc drainage approach may be catching on. I've got a patient in the ICU right now--had bilateral traumatic pneumothoraces with chest tubes about two weeks ago. Went home with the tubes out, and 10 days later admitted with severe sepsis requiring pressors. Has a huge empyema (MRSA). Was too unstable for the OR, and we've used a pigtail catheter for the last several days. Have had (surprisingly) good drainage, and she's responded very well. Still febrile, but off of pressors after 24 hours, now mobilizing all the fluid we used to resucitate her. She'll probably go to the OR for decortication tomorrow. So, perc drainage, at least in my case and yours, Carlos, appears to have been a good approach to temporize prior to definitive surgery.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1118097807977487892005-06-06T18:43:00.000-04:002005-06-06T18:43:00.000-04:00We didn't try fibrinolytics either though the perc...We didn't try fibrinolytics either though the perc drainage bought us some time to optimize his cardiac status prior to surgery.Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1118093696651219432005-06-06T17:34:00.000-04:002005-06-06T17:34:00.000-04:00In the clinical year in review at ATS in pleural d...In the clinical year in review at ATS in pleural disease, they reviewed an article that noted fibrinolytics in empyema are not valuable.<BR/>Maskell NA et al. NEJM 2005; 352: 865-74. <BR/>Based upon this, the surgeons are pretty reticent to use fibrinolytics in an empyema and advocate taking the patient to the OR if possible.<BR/>I suppose there are those who still favor the use (Y-J?), but it remains to be seen in what subpopulation they are valuable.Mike Lhttps://www.blogger.com/profile/12177750268091750583noreply@blogger.com