What question did this study set out to answer?

Determine whether saline lavage alone or with enzyme therapy is superior to enzyme therapy alone for pleural infections.

Saline lavage alone prolongs drainage compared with intrapleural enzyme therapy in pleural infection: The SCOPE trial

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Randomised trial demonstrates prolonged drainage duration in pleural infection with saline lavage, suggesting possible treatment advantage.

Determine whether saline lavage alone or with enzyme therapy is superior to enzyme therapy alone for pleural infections.
Two-center, prospective, randomised superiority trial.
Participants allocated to saline lavage alone, saline lavage plus IET, or IET alone.
Blinding used for patients and outcome assessors.
Primary endpoint: duration of pleural drainage.
Secondary endpoints included radiographic resolution and adverse events.
Median drainage duration was significantly longer with saline lavage alone (4.0 days) compared to IET alone (3.0 days, p=0.01).
No significant difference in drainage duration between saline+IET and IET alone (p=0.24).
Secondary outcomes did not reveal a clear advantage for saline lavage over IET.

Porcel et al. (2026) studied this question.

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Randomised trial demonstrates prolonged drainage duration in pleural infection with saline lavage, suggesting possible treatment advantage.