Status:

COMPLETED

Management of Pleural Space Infections

Lead Sponsor:

Swedish Medical Center

Conditions:

Empyema, Pleural

Parapneumonic Effusion

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

Currently, there is no high-quality evidence comparing the clinical outcomes and cost effectiveness of surgical drainage combined with antibiotics versus dual-agent intrapleural fibrinolytic therapy (...

Detailed Description

Currently, there is no high-quality evidence comparing the clinical outcomes and cost effectiveness of surgical drainage combined with antibiotics versus dual-agent intrapleural fibrinolytic therapy (...

Eligibility Criteria

Inclusion

  • Age \>18 years
  • Clinical presentation compatible with pleural infection (fever or leukocytosis, elevated procalcitonin, elevated C-reactive protein (CRP))
  • Pleural fluid requiring drainage that is either:
  • Macroscopically purulent or
  • Positive on culture for bacterial infection or
  • Positive for bacteria on gram stain or
  • Lactate dehydrogenase (LDH) \> 1000 IU/L or
  • Glucose \<40 mg/dL

Exclusion

  • Age \<18 years
  • Unable to give consent (No surrogate consent of legally authorized representatives allowed for this study)
  • Not proficient in English
  • History of prior ipsilateral empyema
  • Has known sensitivity to DNase or alteplase
  • History of intracranial hemorrhage or acute intracranial hemorrhage
  • History of stroke, hemorrhage, or trauma within the last 3 months
  • Has had prior surgery on the side of the pleural infection
  • Patients who are pregnant or lactating
  • Expected survival less than 6 months from a different pathology to this pleural infection based on clinical judgment
  • Has a tunneled pleural catheter in place
  • Patients on anticoagulation that cannot be interrupted for surgical intervention
  • Patients with known or suspected malignant pleural effusion
  • Patients with renal failure (Creatinine clearance \<30)
  • Prior history of or concern for chylothorax or pseudochylothorax
  • Vulnerable populations: prisoners

Key Trial Info

Start Date :

April 1 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

March 11 2022

Estimated Enrollment :

26 Patients enrolled

Trial Details

Trial ID

NCT03873766

Start Date

April 1 2019

End Date

March 11 2022

Last Update

November 22 2022

Active Locations (1)

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1

Swedish Cancer Institute

Seattle, Washington, United States, 98104