What are the indications for urgent drainage of parapneumonic effusions?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Indications for urgent drainage of parapneumonic effusions include (1) frankly purulent fluid, (2) a pleural fluid pH of less than 7.0-7.1, (3) loculated effusions, and (4) bacteria on Gram stain or culture. [44]

Patients with parapneumonic effusions who do not meet the criteria for immediate tube drainage should improve clinically within one week with appropriate antibiotic treatment.

Reassess patients with parapneumonic effusions who do not improve or who deteriorate clinically, using chest CT scanning and/or ultrasonography to evaluate the pleural space, and direct further drainage attempts, if needed.


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