Compliance and cross-over
Noncompliance with protocol treatment in each of the three arms was defined as follows. For the standard care arm, participants who received IET or surgery during their hospital stay were considered noncompliant. For the IET arm, noncompliance was noted if treatment was abandoned for a reason other than the clinician deeming that the treatment had been completed successfully and no further doses were required. Finally, for the VATS arm, participants who did not receive surgery (with surgical evaluation intended <48 hr after randomization) were considered noncompliant.For safety reasons, cross-over was permitted if a different intervention was deemed clinically necessary (at PI discretion) and the trial intervention could not be achieved within 48 hours of randomization.