Mei F.a,b· Rota M.c· Bonifazi M.a,b· Zuccatosta L.a· Porcarelli F.M.a,b· Sediari M.a· Bedawi E.O.d· Sundaralingam A.d· Addala D.d· Gasparini S.a,b· Rahman N.M.d,e,f

Author affiliations

aRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
bDepartment of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
cDepartment of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
dOxford Pleural Unit, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
eOxford NIHR Biomedical Research Unit, Oxford, UK
fChinese Academy of Medicine Oxford Institute, Oxford, UK

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Article / Publication Details

First-Page Preview

Received: June 17, 2022
Accepted: January 04, 2023
Published online: January 24, 2023

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: Pleural infection represents a significant clinical challenge worldwide. Although prompt drainage of pleural fluid is thought to play a key role in pleural infection management, the optimal size of intrapleural catheter has yet to be defined. Objectives: The aim of this systematic review and meta-analysis was to summarize data on efficacy and complications of small-bore drain (SBD), defined as ≤14F, in comparison to large-bore drain (LBD) in patients with pleural infection. Method: We searched MEDLINE and Embase for all studies reporting outcomes of interest published up to October 2021. Two authors reviewed selected full text to identify studies according to predefined eligibility criteria. Summary estimates were derived using the random-effects model. Results: Twelve original studies were included for qualitative analysis and 7 of these for quantitative analysis. The surgical referral rate of SBD and LBD were, respectively, 0.16 (95% confidence interval [CI], 0.12–0.21) and 0.20 (95% CI, 0.10–0.32), the pooled mortality were 0.12 (95% CI, 0.05–0.21) and 0.20 (95% CI, 0.10–0.32), and the length of hospital stay was 24 days in both groups. Data on complications suggest similar proportions of tube dislodgement. Intensity of pain was evaluated in one study only, reporting higher scores for LBD. Conclusions: This systematic review and meta-analysis provide the first synthesis of data on performance of SBD and LBD in management of pleural infection, and, overall, clinical outcomes and complications did not substantially differ, although the limited number of studies and the absence of dedicated randomized trials does limit the reliability of results.

© 2023 S. Karger AG, Basel

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First-Page Preview

Received: June 17, 2022
Accepted: January 04, 2023
Published online: January 24, 2023

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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