Intrapleural Tissue Plasminogen Activator for Complicated Pleural Effusions
- 1 December 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Trauma-Injury Infection and Critical Care
- Vol. 57 (6), 1178-1183
- https://doi.org/10.1097/01.ta.0000141879.67441.52
Abstract
This study is aimed at evaluating the safety and efficacy of intrapleural tissue plasminogen activator (TPA) for complicated pleural effusions, including posttraumatic hemothorax. Data were retrospectively collected from hospitalized patients over a 4-year period (1999–2003) who were treated with intrapleural TPA after failing drainage by tube thoracostomy. Pre- and post-TPA imaging studies were reviewed and scored by a blinded radiologist. Forty-one consecutive patients with 42 effusions were identified with the following indications: 6 traumatic hemothoraces (14%), 22 loculated pleural effusions (52%), 2 line-associated hemothoraces (5%), and 12 empyemas (29%). Nine patients (22%) required operative drainage including two with posttraumatic hemothoraces. All patients managed nonoperatively demonstrated radiographic improvement after TPA administration. One patient (2.4%) developed hematuria, requiring transfusion. No trauma patient required TPA-related blood transfusion and no deaths were attributable to TPA therapy. Intrapleural TPA administration appears safe for use in complicated pleural effusions and may decrease the need for operative intervention.Keywords
This publication has 24 references indexed in Scilit:
- Management of complicated parapneumonic effusions and thoracic empyemaInternal Medicine Journal, 2002
- Pleural EffusionThe New England Journal of Medicine, 2002
- Posttraumatic EmpyemaEuropean Journal of Trauma, 2002
- Video-Assisted Thoracic Surgery in the Treatment of Posttraumatic EmpyemaArchives of Surgery, 1998
- Early Evacuation of Traumatic Retained Hemothoraces Using Thoracoscopy: A Prospective, Randomized TrialThe Annals of Thoracic Surgery, 1997
- Intrapleural administration of streptokinase in complicated purulent pleural effusion: A CT-guided strategyIntensive Care Medicine, 1996
- Intrapleural Fibrinolysis With Streptokinase as an Adjunctive Treatment in Hemothorax and EmpyemaSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1996
- Empyema of the Thorax in AdultsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1993
- Use of purified streptokinase in empyema and hemothoraxThe American Journal of Surgery, 1991
- THE EFFECT IN PATIENTS OF STREPTOCOCCAL FIBRINOLYSIN (STREPTOKINASE) AND STREPTOCOCCAL DESOXYRIBONUCLEASE ON FIBRINOUS, PURULENT, AND SANGUINOUS PLEURAL EXUDATIONS 1JCI Insight, 1949