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Related Concept Videos

Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Chronic Obstructive Pulmonary Disease II: Emphysema01:23

Chronic Obstructive Pulmonary Disease II: Emphysema

Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.

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Intrapleural therapy in management of complicated parapneumonic effusions and empyema.

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Related Experiment Video

Updated: Jun 6, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
03:22

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

Published on: November 10, 2023

Empyema thoracis.

Ala Eldin H Ahmed1, Tariq E Yacoub

  • 1Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
|December 16, 2010
PubMed
Summary
This summary is machine-generated.

Empyema thoracis, a serious infection, is increasing. Management guidelines exist, but research is needed for optimal treatment of parapneumonic effusions (PPE) and empyema.

Keywords:
drainageempyemaintrapleural fibrinolysismanagementsurgery

More Related Videos

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Related Experiment Videos

Last Updated: Jun 6, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
03:22

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

Published on: November 10, 2023

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Empyema thoracis presents a high mortality rate (6-24%) and an increasing incidence in children and adults.
  • Parapneumonic effusions (PPE) complicate pneumonia in approximately 50% of hospitalized patients, significantly increasing mortality.
  • The natural course of empyema is described in three stages: exudative, fibrinopurulent, and organizing, with clinical classifications including simple PPE, complicated PPE, and frank empyema.

Purpose of the Study:

  • To review current guidelines and evidence for managing parapneumonic effusions and empyema.
  • To highlight areas requiring further research, particularly regarding intrapleural fibrinolysis efficacy.

Main Methods:

  • Review of existing guidelines from the American College of Chest Physicians and British Thoracic Society.
  • Analysis of recent randomized trials and emerging evidence on treatment modalities.
  • Comparison of management strategies for adults and children.

Main Results:

  • Guidelines recommend pleural space drainage for complicated PPE and frank empyema, with varying approaches to intrapleural fibrinolysis and surgery.
  • A recent trial showed no survival advantage for streptokinase, though it aids drainage in specific cases.
  • Emerging evidence suggests intrapleural tPA/DNase combination is superior for pleural fluid drainage.
  • For childhood empyema, guidelines recommend antibiotics plus VATS or tube thoracostomy and fibrinolysis; prospective trials indicate fibrinolysis is as effective and more economical than VATS.

Conclusions:

  • While guidelines exist for PPE and empyema management, the evidence for intrapleural fibrinolysis requires further investigation.
  • Intrapleural tPA/DNase shows promise for improving pleural fluid drainage.
  • Intrapleural fibrinolysis is a cost-effective primary treatment option for childhood empyema.