Pulmonology

AATS: New Guidelines for Empyema

The American Association for Thoracic Surgery has released new evidence-based guidelines on the management of empyema.

The guidelines are based upon an evidence review conducted by the AATS’s Empyema Management Guidelines Working Group, which was made up on experts from disciplines including thoracic surgery, pulmonary and critical care, infectious disease, and interventional radiology.
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The guidelines discussed disease presentation, diagnosis, and treatment strategies. The recommendations included the following:

  • Video assisted thoracoscopicsurgery is recommended as the first line of treatment for patients with stage II acute empyema.
  • Despite advances in antibiotics, radiologic imaging, and pharmacological treatments, surgery remains the most effective method for managing empyema.
  • Patients with pneumonia who fail to respond to antibiotics or who have unexplained sepsis should be evaluated for pleural effusion.

The guidelines also include recommendations for pediatric patients with empyema.

—Melissa Weiss

Reference:

Shen KR, Bribriesco A, Crabtree T, et al. The American Association for Thoracic Surgery consensus guidelines for the management of empyema [published online February 4, 2017]. J Thorac Cardiovasc Surg. doi:10.1016/j.jtcvs.2017.01.030.