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
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.