Pleural irrigation trial (PIT): A randomised controlled trial of pleural irrigation with normal saline versus standard care in patients with pleural infection

Maskell, Nick A.; Zahan-Evans, Natalie; Harvey, John E.; Medford, Andrew R.L.; Clive, Amelia O.; Edey, Anthony J.; Hooper, Clare E.; Hooper, Clare E; Edey, Anthony J; Wallis, Anthony; Clive, Amelia O; Morley, Anna; White, Paul; Medford, Andrew R L; Harvey, John E; Darby, Mike; Zahan Evans, Natalie; Maskell, Nick A

Abstract

© ERS 2015. Pleural infection is increasing in incidence. Despite optimal medical management, up to 30% of patients will die or require surgery. Case reports suggest that irrigation of the pleural space with saline may be beneficial. A randomised controlled pilot study in which saline pleural irrigation (three times per day for 3 days) plus best-practice management was compared with best-practice management alone was performed in patients with pleural infection requiring chest-tube drainage. The primary outcome was percentage change in computed tomography pleural fluid volume from day 0 to day 3. Secondary outcomes included surgical referral rate, hospital stay and adverse events. 35 patients were randomised. Patients receiving saline irrigation had a significantly greater reduction in pleural collection volume on computed tomography compared to those receiving standard care (median (interquartile range) 32.3% (19.6-43.7%) reduction versus 15.3% (-5.5-28%) reduction) ( p

• Journal Article Type: Article
• Publication Date: Jan 1, 2015
• Journal: European Respiratory Journal
• Print ISSN: 0903-1936
• Electronic ISSN: 1399-3003
• Publisher: European Respiratory Society
• Peer Reviewed: Peer Reviewed
• Volume: 46
• Issue: 2
• Pages: 456-463
• DOI: https://doi.org/10.1183/09031936.00147214
• Keywords: PIT trial, saline irrigation, pleural infection
• Public URL: https://uwe-repository.worktribe.com/output/830191
• Publisher URL: http://dx.doi.org/10.1183/09031936.00147214