| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Department of Surgery, University of New Mexico School of Medicine, Albuquerque
Study objective: To determine the success and complication rates of fibrinolytic therapy (FL) in the treatment of thoracic empyema.
Design and patients: Between December 1992 and November 1994, all patients referred with empyema thoracis (ET) were offered FL. FL consisted of streptokinase (275,000±170,000 IU) or urokinase (121,000±57,000 IU) daily for a mean of 6.2±2.1 days.
Setting: The University of New Mexico Health Sciences Center and the Albuquerque Veterans Affairs Medical Center.
Results: Twenty-six patients were treated. Sixty-two percent (16/26) had complete resolution (CR) of symptoms, near or complete normalization of chest radiographic findings, and required no surgery or empyema tubes. Eight percent (2/26) had relief of symptoms and partial resolution (PR) of radiographic abnormalities and were discharged from the hospital with empyema tubes in place. All patients with PR had empyema tubes removed within 30 days of hospital discharge. Thirty-one percent (8/26) of patients failed to completely improve clinically or radiographically (nonresponse) and were treated with decortication or empyema tubes for greater than 30 days. Bleeding occurred in a single patient (4%). There was no mortality associated with FL use.
Conclusions: The use of FL is associated with resolution of ET in 69% (18/26) of patients. This modality is safe, effective, and spares most patients with empyema the morbidity and mortality of thoracotomy.
Key Words: empyema • streptokinase • urokinase
Submitted on October 19, 1995
Accepted on February 28, 1996
This article has been cited by other articles:
|
|
 |
|
  Y. Tokuda, D. Matsushima, G. H. Stein, and S. Miyagi Intrapleural Fibrinolytic Agents for Empyema and Complicated Parapneumonic Effusions: A Meta-analysis Chest, March 1, 2006; 129(3): 783 - 790. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Light Parapneumonic effusions and empyema. Proceedings of the ATS, January 1, 2006; 3(1): 75 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ozcelik, R. Ulku, S. Onat, Z. Ozcelik, I. Inci, and O. Satici Management of postpneumonic empyemas in children Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 1072 - 1078. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ozcelik, I. Inci, O. Nizam, and S. Onat Intrapleural fibrinolytic treatment of multiloculated postpneumonic pediatric empyemas Ann. Thorac. Surg., December 1, 2003; 76(6): 1849 - 1853. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Roberts Minimally invasive surgery in the treatment of empyema: intraoperative decision making Ann. Thorac. Surg., July 1, 2003; 76(1): 225 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C W H Davies, F V Gleeson, and R J O Davies BTS guidelines for the management of pleural infection Thorax, May 1, 2003; 58(90002): ii18 - 28. [Full Text]
|
|
|
|
|
|
A. E. Balci, S. Eren, R. Ulku, and M. N. Eren Management of multiloculated empyema thoracis in children: thoracotomy versus fibrinolytic treatment Eur. J. Cardiothorac. Surg., October 1, 2002; 22(4): 595 - 598. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Ghaye and R.F. Dondelinger Imaging guided thoracic interventions Eur. Respir. J., March 1, 2001; 17(3): 507 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Colice, A. Curtis, J. Deslauriers, J. Heffner, R. Light, B. Littenberg, S. Sahn, R. A. Weinstein, and R. D. Yusen Medical and Surgical Treatment of Parapneumonic Effusions : An Evidence-Based Guideline Chest, October 1, 2000; 118(4): 1158 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Simpson, D. Roomes, and M. Heron Effects of Streptokinase and Deoxyribonuclease on Viscosity of Human Surgical and Empyema Pus Chest, June 1, 2000; 117(6): 1728 - 1733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sasse, T. Nguyen, L. R. Teixeira, and R. Light The Utility of Daily Therapeutic Thoracentesis for the Treatment of Early Empyema* Chest, December 1, 1999; 116(6): 1703 - 1708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. Lim and A. P. C. Yim Management of Pleural Empyema Chest, September 1, 1999; 116(3): 845 - 846. [Full Text] [PDF]
|
|
|
|
|
|
C. W. H. Davies, Z. C. Traill, F. V. Gleeson, and R. J. O. Davies Intrapleural Streptokinase in the Management of Malignant Multiloculated Pleural Effusions Chest, March 1, 1999; 115(3): 729 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Cassina, M. Hauser, L. Hillejan, D. Greschuchna, and G. Stamatis VIDEO-ASSISTED THORACOSCOPY IN THE TREATMENT OF PLEURAL EMPYEMA: STAGE-BASED MANAGEMENT AND OUTCOME J. Thorac. Cardiovasc. Surg., February 1, 1999; 117(2): 234 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. BOUROS, S. SCHIZA, N. TZANAKIS, G. CHALKIADAKIS, J. DROSITIS, and N. SIAFAKAS Intrapleural Urokinase versus Normal Saline in the Treatment of Complicated Parapneumonic Effusions and Empyema . A Randomized, Double-Blind Study Am. J. Respir. Crit. Care Med., January 1, 1999; 159(1): 37 - 42. [Abstract] [Full Text]
|
|
|
|
|
|
C. W. H. DAVIES, S. LOK, and R. J. O. DAVIES The Systemic Fibrinolytic Activity of Intrapleural Streptokinase Am. J. Respir. Crit. Care Med., January 1, 1997; 157(1): 328 - 330. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
