Journal Club July 2022

Australasian Malignant PLeural Effusion (AMPLE)-3 trial: study protocol for a multi-centre randomised study comparing indwelling pleural catheter (±talc pleurodesis) versus video-assisted thoracoscopic surgery for management of malignant pleural effusion. 

Fitzgerald DB, et al.


The protocol for the third in the series of AMPLE trials of malignant pleural disease. This trial aims to establish the efficacy of a VATS pleurodesis compared to talc pleurodesis via an IPC. The primary outcome is a pragmatic assessment of pleurodesis “the need for further ipsilateral pleural interventions over 12 months or until death, if sooner”. Secondary outcomes include days in hospital, quality of life (QoL) measures, physical activity levels, safety profile, health economics, adverse events, and survival. The trial aims to recruit 158 participants who will be followed up for 12 months.

Complications of cerebral air embolism associated with pleural lavage for empyema. 

Ishihara T, et al.

BMJ Case Rep.

A scary but mercifully rare complication of pleural lavage.