Pleural antiseptic irrigation (PAI) is used in conjunction with open drainage for treating adults with chronic post-thoracotomy empyema. The antiseptic povidone-iodine can safely be instilled into the pleural cavity for the purpose of pleurodesis and has recently been described for pleural irrigation in the acute management of paediatric pleural infection with good outcomes. A recent case report demonstrated the safe use of povidone-iodine pleural irrigation in a patient with complex pleural empyema with successful medical management. In a previous pilot study, antiseptic irrigation led to less referral to surgery and shorter length of hospital stay in comparison to no irrigation. This study aims to investigate the effect of antiseptic pleural irrigation (using povidone iodine) on the inflammatory response in adults patients with pleural infection in comparison to irrigation with normal saline alone. A reduction in the systemic inflammatory response can be inferred to correlate with reduction in the infection burden in the pleural space.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
44
Pleural irrigation with 2% povidone iodine
Pleural irrigation with normal saline
Alexandria University Faculty of Medicine
Alexandria, Egypt
RECRUITINGPercentage change in inflammatory markers before and after irrigation
The percentage by which inflammatory marker (CRP and/or procalcitonin) decrease after completing all irrigations in comparison to the pre-irrigation inflammatory markers level
Time frame: Initial levels to be measured 12 to 48 hours post tube insertion and follow up levels 12 to 24 hours post last dose of irrigation
Time in days to chest tube removal
The time in days from the first irrigation to the chest tube removal
Time frame: At the time of chest tube removal (up to 6 weeks)
Total length of hospital stay in days
Duration of hospital stay from admission until a patient is declared medically fit for discharge
Time frame: At the point of deciding a patient is medically fit for discharge (assessed up to 6 weeks)
Percentage of radiological clearance between baseline and discharge chest X-rays
Percentage of radiological clearance of pleural abnormalities between baseline and discharge chest X-rays using a computer software
Time frame: baseline and discharge (up to week 6)
Incidence of medical treatment failure
Number of patients who fail medical treatment (referral to surgery, further pleural procedures or death)
Time frame: At discharge from the hospital or referral to another department (assessed up to week 6)
Incidence of adverse events
Number of patients with different types of adverse events
Time frame: Adverse events will be recognised if they appear within 6 hours of a given irrigation procedure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.