E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study

K. Prasanna Kumar Reddy.

Abstract
Background: The aim of pleural effusion management is to provide symptomatic relief by draining excessive fluid in the pleural space and stable the patient before the surgical and therapeutic intervention of underlying disease. Intrapleural fibrinolytic therapy is an effectively adjunct to improve the drainage of loculated effusion in complicated empyema especially in cases who fail chest tube drainage.

Aim and Objectives: The aim of the study was to compare the efficacy of intrapleural instillation of 2-mercaptoethane sulfonate sodium (MESNA) and conservative approach in the management of loculated parapneumonic effusion and thoracic empyema.

Materials and Methods: A total of 50 cases with loculated parapneumonic effusion and empyema above 21 years of age were recruited. Cases were randomly divided into two groups, that is, Group 1 managed with intrapleural instillation of MESNA for adhesiolysis of loculations through tube thoracostomy and Group 2 managed with conservative approach through tube thoracostomy.

Results: Effusion in 84–80% and empyema in 16–20% were observed in Group 1 and Group 2, respectively. The mean value of number of days in ICD was 14.98 days in Group 1 and 19.5 days in Group 2. The amount of fluid drained (125.3–95.6 ml) and mean duration of hospital stay (22.2–28.5) was statistically significant between study groups. No adverse complications were noticed; however, cough and pain at the site of injection were reported in two cases each. Around, 32–64% cases required surgical intervention in Group 1 and Group 2, respectively.

Conclusion: The intrapleural fibrinolytic therapy by 2-MESNA has better efficacy than conservative thoracostomy. The MENSA has better outcome in regard to breaking loculations, limited requirement of surgical intervention, less duration of hospital stay, and faster absorption of pleural fluid in effusion and empyema.

Key words: 2-Mercaptoethane Sulfonate Sodium; Pleural Effusion; Empyema; Septations


 
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Pubmed Style

K. Prasanna Kumar Reddy. Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. Natl J Physiol Pharm Pharmacol. 2022; 12(6): 777-780. doi:10.5455/njppp.2022.12.11405202122112021


Web Style

K. Prasanna Kumar Reddy. Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. https://www.njppp.com/?mno=138634 [Access: June 01, 2022]. doi:10.5455/njppp.2022.12.11405202122112021


AMA (American Medical Association) Style

K. Prasanna Kumar Reddy. Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. Natl J Physiol Pharm Pharmacol. 2022; 12(6): 777-780. doi:10.5455/njppp.2022.12.11405202122112021



Vancouver/ICMJE Style

K. Prasanna Kumar Reddy. Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. Natl J Physiol Pharm Pharmacol. (2022), [cited June 01, 2022]; 12(6): 777-780. doi:10.5455/njppp.2022.12.11405202122112021



Harvard Style

K. Prasanna Kumar Reddy (2022) Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. Natl J Physiol Pharm Pharmacol, 12 (6), 777-780. doi:10.5455/njppp.2022.12.11405202122112021



Turabian Style

K. Prasanna Kumar Reddy. 2022. Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. National Journal of Physiology, Pharmacy and Pharmacology, 12 (6), 777-780. doi:10.5455/njppp.2022.12.11405202122112021



Chicago Style

K. Prasanna Kumar Reddy. "Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study." National Journal of Physiology, Pharmacy and Pharmacology 12 (2022), 777-780. doi:10.5455/njppp.2022.12.11405202122112021



MLA (The Modern Language Association) Style

K. Prasanna Kumar Reddy. "Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study." National Journal of Physiology, Pharmacy and Pharmacology 12.6 (2022), 777-780. Print. doi:10.5455/njppp.2022.12.11405202122112021



APA (American Psychological Association) Style

K. Prasanna Kumar Reddy (2022) Management of parapneumonic effusion and thoracic empyema with intrapleural instillation of 2-mercaptoethane sulfonate sodium and conservative approach – A comparative study. National Journal of Physiology, Pharmacy and Pharmacology, 12 (6), 777-780. doi:10.5455/njppp.2022.12.11405202122112021