[Long-term outcome of intrapleural fibrinolytic therapy via small-bore catheter drainage in the management of complicated parapneumonic effusion and empyema-a case series].

Abstract

BACKGROUND AND PURPOSE:

Complicated parapneumonic effusions (PPE) and pleural empyemas (PE) are associated with increased morbidity and mortality. Intrapleural fibrinolytic therapy (IFT) has been established, besides video-assisted thoracoscopy (VATS), in the management of PPE and PE. Combination of IFT and small-bore catheter drainage has previously not been investigated.

PATIENTS AND METHODS:

15 patients consecutively referred for PPE and PE were managed with simultaneous IFT via small-bore catheter drainage (9, 12, 14 F). In addition to evaluation of primary outcome, lung function testing and radiologic studies were obtained after 3 months to predict potential pulmonary restrictive impairment and residual pleural thickening.

RESULTS:

Primary outcome of all 15 patients was positive. Only one patient showed a significant residual pleural thickening. None of the patients showed a restrictive lung function pattern.

CONCLUSION:

Proven applicability of IFT via small-bore catheter drainage seems to be effective in the face of long-term outcome. Further prospective and multicentric studies should be initiated to investigate the practicability of IFT via small-bore catheter drainage.

• Authors: Selçuk Tasci, Alexandra Burghard, Harald Schäfer, Christian Rabe, Santiago Ewig, Berndt Lüderitz
• Journal: Medizinische Klinik (Munich, Germany : 1983) (Med Klin (Munich)) Vol. 100 Issue 4 Pg. 181-5 (Apr 15 2005) ISSN: 0723-5003 [Print] Germany
• Vernacular Title: Langzeitergebnisse der intrapleuralen Fibrinolytikatherapie komplizierter parapneumonischer Pleuraergüsse und Empyeme über kleinlumige Katheter.
• PMID: 15834526 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Plasminogen Activators
• Urokinase-Type Plasminogen Activator

Topics

• Adult
• Aged
• Aged, 80 and over
• Data Interpretation, Statistical
• Drainage (instrumentation)
• Empyema, Pleural (diagnosis, diagnostic imaging, etiology, therapy)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Plasminogen Activators (administration & dosage)
• Pleural Effusion (diagnosis, diagnostic imaging, etiology, therapy)
• Pneumonia (complications)
• Prognosis
• Radiography, Thoracic
• Respiratory Function Tests
• Risk Factors
• Thrombolytic Therapy (instrumentation, methods)
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (administration & dosage)