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Case reports suggest that irrigation of the pleural space with saline may be beneficial.<\/jats:p><jats:p>A randomised controlled pilot study in which saline pleural irrigation (three times per day for 3\u2005days) plus best-practice management was compared with best-practice management alone was performed in patients with pleural infection requiring chest-tube drainage. The primary outcome was percentage change in computed tomography pleural fluid volume from day 0 to day 3. Secondary outcomes included surgical referral rate, hospital stay and adverse events.<\/jats:p><jats:p>35 patients were randomised. Patients receiving saline irrigation had a significantly greater reduction in pleural collection volume on computed tomography compared to those receiving standard care (median (interquartile range) 32.3% (19.6\u201343.7%) reduction<jats:italic>versus<\/jats:italic>15.3% (\u22125.5\u201328%) reduction) (p&lt;0.04). Significantly fewer patients in the irrigation group were referred for surgery (OR 7.1, 95% CI 1.23\u201341.0; p=0.03). There was no difference in length of hospital stay, fall in C-reactive protein, white cell count or procalcitonin or adverse events between the treatment groups, and no serious complications were documented.<\/jats:p><jats:p>Saline irrigation improves pleural fluid drainage and reduces referrals for surgery in pleural infection. A large multicentre randomised controlled trial is now warranted to evaluate its effects further.<\/jats:p>","DOI":"10.1183\/09031936.00147214","type":"journal-article","created":{"date-parts":[[2015,5,29]],"date-time":"2015-05-29T03:06:18Z","timestamp":1432868778000},"page":"456-463","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":89,"title":["Pleural irrigation trial (PIT): a randomised controlled trial of pleural irrigation with normal saline<i>versus<\/i>standard care in patients with pleural infection"],"prefix":"10.1183","volume":"46","author":[{"given":"Clare E.","family":"Hooper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Edey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Wallis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia O.","family":"Clive","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Morley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.L.","family":"Medford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Darby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Zahan-Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick A.","family":"Maskell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2015,5,28]]},"reference":[{"key":"2024102023315986000_46.2.456.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.4.1158"},{"key":"2024102023315986000_46.2.456.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.3.731"},{"key":"2024102023315986000_46.2.456.3","doi-asserted-by":"publisher","DOI":"10.1097\/00001432-199804000-00013"},{"key":"2024102023315986000_46.2.456.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(00)00499-2"},{"key":"2024102023315986000_46.2.456.5","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2001.1176"},{"key":"2024102023315986000_46.2.456.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.137000"},{"key":"2024102023315986000_46.2.456.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042473"},{"key":"2024102023315986000_46.2.456.8","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(80)90460-X"},{"key":"2024102023315986000_46.2.456.9","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/89.4.285"},{"key":"2024102023315986000_46.2.456.10","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.160.5.9903002"},{"key":"2024102023315986000_46.2.456.11","doi-asserted-by":"publisher","DOI":"10.1042\/CS20030115"},{"key":"2024102023315986000_46.2.456.12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10102411"},{"key":"2024102023315986000_46.2.456.13","doi-asserted-by":"publisher","DOI":"10.1345\/aph.18219"},{"key":"2024102023315986000_46.2.456.14","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.1.9001327"},{"key":"2024102023315986000_46.2.456.15","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.1.9803094"},{"key":"2024102023315986000_46.2.456.16","doi-asserted-by":"publisher","DOI":"10.1136\/thx.52.5.416"},{"key":"2024102023315986000_46.2.456.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012740"},{"key":"2024102023315986000_46.2.456.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.10.003"},{"key":"2024102023315986000_46.2.456.19","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1013115"},{"key":"2024102023315986000_46.2.456.20","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.2.272"},{"key":"2024102023315986000_46.2.456.21","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.5.3303"},{"key":"2024102023315986000_46.2.456.22","doi-asserted-by":"crossref","unstructured":"Loddenkemper R , Kaiser D , Frank W . 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