Trial reportBMC pulmonary medicine2022
A feasibility randomised trial comparing therapeutic thoracentesis to chest tube insertion for the management of pleural infection: results from the ACTion trial.
Trial report in BMC pulmonary medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Early Video-assisted Thoracoscopic Surgery or Intrapleural Enzyme Therapy in Pleural Infection: A Feasibility Randomized Controlled Trial. The Third Multicenter Intrapleural Sepsis Trial-MIST-3.American journal of respiratory and critical care medicine · 2023Trial
- Managing pleural infections: a nationwide survey of respiratory physicians in Singapore.BMJ open respiratory research · 2026Article
- Local management of pleural infection: a narrative review.European journal of medical research · 2026Review
- What is new in pleural infections?Breathe (Sheffield, England) · 2026Review
- A Practical Approach to Pleural Infection.Pulmonary therapy · 2025Article
- Pleural Empyema in Spain (2016-2022): A Nationwide Study on Trends in Hospitalizations, Mortality, and Impact of Comorbidities.Journal of personalized medicine · 2025Article
- Chest tube drainage versus repeated therapeutic thoracentesis for the management of pleural infections: a retrospective multicentre propensity-matched study.Pneumonia (Nathan Qld.) · 2025Article
- Chest drainage or repeated thoracentesis for pleural infections: a clinical dilemma.Pneumonia (Nathan Qld.) · 2025Article
- Pleural Infection: Diagnosis, Management, and Future Directions.Journal of clinical medicine · 2025Review
- Missed Foreign Body Aspiration: Fentanyl Patch Leading to Severe Pneumonia and Empyema.Cureus · 2025Article
- Diagnosis and management of pleural infection.Breathe (Sheffield, England) · 2023Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPleural infection is a complex condition with a considerable healthcare burden. The average hospital stay for pleural infection is 14 days. Current standard of care defaults to chest tube insertion and intravenous antibiotics. There have been no randomised trials on the use of therapeutic thoracentesis (TT) for pleural fluid drainage in pleural infection. AIMS AND
objectivesTo assess the feasibility of a full-scale trial of chest tube vs TT for pleural infection in a single UK centre. The primary outcome was defined as the acceptability of randomisation to patients.
methodsAdult patients admitted with a pleural effusion felt to be related to infection and meeting criteria for drainage (based on international guidelines) were eligible for randomisation. Participants were randomised (1:1) to chest tube insertion or TT with daily review assessing need for further drainages or other therapies. Neither participant nor clinician were blinded to treatment allocation. Patients were followed up at 90 days post-randomisation.
resultsFrom September 2019 to June 2021, 51 patients were diagnosed with pleural infection (complex parapneumonic effusion/empyema). Eleven patients met the inclusion criteria for trial and 10 patients were randomised (91%). The COVID-19 pandemic had a substantial impact on recruitment. Data completeness was high in both groups with no protocol deviations. Patients randomised to TT had a significantly shorter overall mean hospital stay (5.4 days, SD 5.1) compared to the chest tube control group (13 days, SD 6.0), p = 0.04. Total number of pleural procedures required per patient were similar, 1.2 in chest tube group and 1.4 in TT group. No patient required a surgical referral. Adverse events were similar between the groups with no readmissions related to pleural infection.
conclusionsThe ACTion trial met its pre-specified feasibility criteria for patient acceptability but other issues around feasibility of a full-scale trial remain. From the results available the hypothesis that TT can reduce length of stay in pleural infection should be explored further.
trial registrationISRCTN: 84674413.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.