AB 24. Intrapleural t-PA administration in patients with complicated parapneumonic effusions
Background: Parapneumonic effusions are developed in half of
hospitalized patients with pneumonia and are followed by many
complications and high mortality. Intrapleural t-PA effusion promotes
pleural drainage by its fibrinolytic activity.
Patients and methods: A total of 18 consecutive patients with
complicated parapneumonic effysion (CPE) were included (patients
with empyema were excluded). Chest tube was inserted under CT
guidance. After drainage of the effusion, 25 mg of t-PA was administered
for 2 consecutive days and the tube was clapped for 5 hours. When the
tube was open again, pressure –20 cmH2O was discharged via chest
tube and vacum. Patient’s spirometry, 6 minute walking test (6MWT)
and X-ray were evaluated before, after and one month after discharge
and t-PA effusion.
Results: The results of the study are presented in the Table 1. Mean pleural fluid production was 717±775 before and 1,516±240 after t-PA
(P<0.001). Most common adverse events were pleural pain (9/18) and
minor hemorrhage at the site of chest tube insertion (2/18).
Conclusions: Existing data are not sufficient enough to support
evidence to the use of fibrinolytics, such as t-PA.
Full table
