IMPACT
Research type
Research Study
Full title
Initial Management of Pleural infection: Aspiration vs Chest Tube (IMPACT) trial
IRAS ID
357237
Contact name
David Arnold
Contact email
Sponsor organisation
North Bristol NHS Trust
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Pleural infection is a serious condition, affecting over 10,000 people per year in the UK. The condition can affect anyone but is more likely to affect those who are elderly or have a weakened immune system. These groups are also the most harmed by long stays in hospital. The current practice to remove the fluid is to insert a chest tube between the ribs, to allow fluid to drain into a collection bottle. This tube stays in place until all the fluid has come out, which usually takes between 3-5 days. The drain can be sore and prevents people moving around normally. Patients need to stay in hospital whilst the drain is in position.
IMPACT aims to reduce the length of time patients with pleural infection need to stay in hospital by using a less invasive single drainage approach called therapeutic thoracentesis for the infected fluid might allow patients to be more mobile. Patients who consent to the study will be randomly assigned to have their fluid drained using a chest tube or therapeutic thoracentesis. Using a less invasive single drainage approach may get patients out of hospital sooner.
As important as draining the fluid is treating the infection with antibiotics, but there is uncertainty about how well antibiotics work in the infected fluid and how best to give them (through the vein or as tablets). Patients are therefore given long courses of antibiotics through the vein (intravenous antibiotics), a problem for antibiotic resistance. Part of IMPACT is collecting samples from patients who take part to see how well antibiotics have reached the infected pleural fluid.
REC name
Wales REC 2
REC reference
25/WA/0302
Date of REC Opinion
20 Nov 2025
REC opinion
Further Information Favourable Opinion