Comparing Once Daily Versus Twice Daily Intrapleural Enzyme Therapy for Treating Complicated Pleural Infections and Empyema

What this Trial Is About

This research aims to find out if giving certain medications once a day works as well as giving them twice a day to treat infections around the lungs, called pleural infections. The study focuses on tissue plasminogen activator tPA and deoxyribonuclease DNase, which are placed through a chest tube into the space between the lung and chest wall to help clear the infection. Researchers want to know if daily dosing is as effective as twice daily dosing and if there are differences in outcomes or fluid remaining in the chest seen on X-rays. Participants are randomly assigned to receive intrapleural enzyme therapy either once daily or twice daily for three consecutive days. The medications tPA and DNase are given through the chest tube as part of this therapy. One group receives the medications once daily, while the other group receives them twice daily, allowing comparison of these dosing schedules. Participants will be hospital patients with a lung infection who already have a chest tube to drain infected fluid. They will provide consent and be monitored throughout the study. Researchers will check outcomes such as surgery or death within 90 days, chest tube drainage, length of hospital stay, pain medication use, infection markers like white blood cell count and C-reactive protein, fever changes, and chest X-ray findings. Safety including bleeding requiring blood transfusion will also be followed. Total participation covers the treatment period and a 90-day follow-up for key outcomes.

Once Daily Intrapleural Enzyme Therapy in Complicated Parapneumonic Effusion or Empyema