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Laboratory and Animal Investigations |

The Utility of Daily Therapeutic Thoracentesis for the Treatment of Early Empyema*

Scott Sasse, MD, FCCP; Tan Nguyen, MD; Lisete R. Teixeira, MD; Richard Light, MD, FCCP
Author and Funding Information

*From the Pulmonary Disease Division, Department of Veterans Affairs Medical Center (Drs. Sasse, Nguyen, and Teixeira), Long Beach, CA; and Saint Thomas Hospital and Vanderbilt University (Dr. Light), Nashville, TN.

Correspondence to: Richard W. Light, MD, FCCP, Director of Pulmonary Disease Program, Saint Thomas Hospital, PO Box 380, 4220 Harding Rd, Nashville, TN



Chest. 1999;116(6):1703-1708. doi:10.1378/chest.116.6.1703
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Study objectives: 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.

Design and interventions: 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.

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