Chest Drain Regular Flushing in Complicated Parapneumonic Effusions and Empyemas

Last updated: April 25, 2025
Sponsor: Vanderbilt University Medical Center
Overall Status: Active - Recruiting

Phase

N/A

Condition

Hot Flash

Treatment

Saline Flush

Clinical Study ID

NCT06427538
231367
  • Ages > 18
  • All Genders

Study Summary

Infections of the pleural space are common, and patients require antibiotics and chest drain placement to evacuate the chest from the infected fluid. Chest drains can get blocked by the drainage fluid and material. For this reason, it is thought that flushing the chest drain with saline solution, can help maintain the patency of the tube. This proposed study will evaluate the impact of regular chest drain flushing on the length of time to chest tube removal and total hospitalization as well as improvement in chest imaging and the need for additional interventions on the infected space.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients with complicated parapneumonic pleural effusion and empyema requiring chesttube placement as standard of care for inpatient management of their pleural spaceinfection with or without intrapleural tissue plasminogen activator anddeoxyribonuclease therapy

  • Age > 18 years old.

Exclusion

Exclusion Criteria:

  • Patients who have surgical tubes that can't accommodate a three-way stopcock.

  • Study subject has any disease or condition that interferes with the safe completionof the study.

  • Inability to provide informed consent.

  • Inability to undergo a chest X-ray.

  • If the managing clinician believes the chest tube will be placed for less than 24hours.

  • Patients with an indwelling pleural catheter (IPC)

Study Design

Total Participants: 96
Treatment Group(s): 1
Primary Treatment: Saline Flush
Phase:
Study Start date:
June 21, 2024
Estimated Completion Date:
October 30, 2025

Study Description

There are no randomized controlled trials (RCTs) evaluating the role of regular chest tube flushing in the setting of pleural space infection for optimal drainage and treatment outcomes. Most studies of <16 Fr catheters have used both flushing and suction to decrease the likelihood of catheter blockage and improve drainage efficiency, however, this practice has never been studied prospectively or in RCTs. Regular flushing (e.g., 20-30 ml saline every 6 h via a three-way tap) is recommended for small chest drains by the British Thoracic Society (BTS) 2010 Guidelines. This practice is followed variably by some and not used by others. Importantly, the role of this practice in successful drainage of infected fluid, and patient-centric outcomes has not been investigated. Inconsistent flushing practices confound the interpretation of therapeutic modalities (such as intrapleural tissue plasminogen activator and deoxyribonuclease therapy) success or lack thereof and limit the execution of RCTs and prospective studies of the pleural space in the setting of infection.

Connect with a study center

  • Mount Sinai

    New York City, New York 10029
    United States

    Active - Recruiting

  • Vanderbilt University Medical Center

    Nashville, Tennessee 37203
    United States

    Active - Recruiting

  • Virginia Commonwealth University

    Richmond, Virginia 23298
    United States

    Active - Recruiting

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.