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Prise en charge des épanchements parapneumoniques compliqués : état des lieux des pratiques en France [The management of complicated parapneumonic effusions in France.]

Abstract : INTRODUCTION: There are no French guidelines for the management of complicated parapneumonic effusions. A national observational study was carried out to assess the main features of current clinical practice for this condition. MATERIAL AND METHODS: A questionnaire was sent by email to the 1500 members of the Société de Pneumologie de Langue Française (SPLF) between 15th November and 15th December 2012. RESULTS: There were 92 responders, i.e. a response rate of 6%. Of these, 87 physicians mentioned that they were involved in the management of patients with complicated parapneumonic effusions with a median number of cases of 10 per year (IQR: 5-20). Chest tube drainage was the main approach used for pleural fluid aspiration (n=51/87), followed by repeated thoracentesis (n=29/87) and early surgery (1/87). Five physicians answered both chest tube drainage or repeated thoracentesis and one physician either chest tube drainage or early surgery. Pleural fibrinolytics were never used by 20% of physicians, only in case of loculations by 70% and by 10% of respondents in all cases. Only 3 physicians combined fibrinolytics with DNAse. A double antibiotic dose was used by one third of physicians. All the physicians used respiratory physiotherapy during hospitalization and to aid recovery. Follow-up practices were heterogeneous. CONCLUSIONS: The management of complicated parapneumonic effusions varies significantly in France. National guidelines may be helpful to define best practice and aid in its implementation.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01146851
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Submitted on : Wednesday, April 29, 2015 - 11:26:31 AM
Last modification on : Tuesday, March 24, 2020 - 2:56:29 PM

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F. Bénézit, J. Letheulle, M. Kerjouan, B. Desrues, S. Jouneau. Prise en charge des épanchements parapneumoniques compliqués : état des lieux des pratiques en France [The management of complicated parapneumonic effusions in France.]. Revue des Maladies Respiratoires, Elsevier Masson, 2015, 32 (9), pp.936-940. ⟨10.1016/j.rmr.2015.01.001⟩. ⟨hal-01146851⟩

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