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A combined intrapleural administration of dornase alfa and tissue plasminogen activator is safe in children with empyema - A pilot study.

AbstractOBJECTIVE:
There is still no consensus regarding the treatment of empyema in children. Intrapleural combination of tissue plasminogen activator and dornase alfa is a promising treatment for empyema in adults. The aim of this pilot study was to determine whether this combination is safe and successful in pediatric empyema.
METHODS:
Previous well children diagnosed with empyema as classified by the British Thoracic Society. After chest tube insertion, intrapleurally dornase alfa 2.5 mg for 2 days and tissue plasminogen activator 0.15 mg/kg for 3 days was given after which the chest tube was clamped for 4 h. Primary outcome was safety.
RESULTS:
Ten consecutive children were included (4 boys, aged 3.2 (1.3-15.0) years old). No serious adverse events were seen. One child developed urticaria but additional intervention or cessation of the trial was not needed. There was no bleeding or mortality and no additional procedures were performed. The median hospital stay after intervention was 7.5 days.
CONCLUSIONS:
The intrapleural treatment of dornase alfa and tissue plasminogen activator as treatment of empyema was safe in ten children with empyema. If confirmed in further studies, this combination of intrapleural therapy may improve the management of pediatric empyema.
AuthorsMonique A Slaats, Jozef De Dooy, Kim Van Hoorenbeeck, Paul E Y Van Schil, Stijn L Verhulst, Jeroen M H Hendriks
JournalActa chirurgica Belgica (Acta Chir Belg) Vol. 121 Issue 3 Pg. 184-188 (Jun 2021) ISSN: 0001-5458 [Print] England
PMID31750793 (Publication Type: Journal Article)
Chemical References
  • Fibrinolytic Agents
  • Recombinant Proteins
  • Deoxyribonuclease I
  • dornase alfa
  • Tissue Plasminogen Activator
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Deoxyribonuclease I
  • Empyema, Pleural (drug therapy)
  • Female
  • Fibrinolytic Agents (therapeutic use)
  • Humans
  • Infant
  • Male
  • Pilot Projects
  • Recombinant Proteins
  • Tissue Plasminogen Activator

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