A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients
Indwelling Pleural Catheters (IPC) are increasingly being used for management of recurrent pleural effusions (RPEs). Use of IPC for management of both malignant and non-malignant recurrent pleural effusions has been associated with complications such as dysfunctional or nonfunctioning IPCs. Alteplas...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007121000824 |
| _version_ | 1819102591830720512 |
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| author | Naureen Narula Nakul Katyal Mohammed Salem Akshay Avula Abdulhassan Siddiqui Rabih Maroun Michel Chalhoub |
| author_facet | Naureen Narula Nakul Katyal Mohammed Salem Akshay Avula Abdulhassan Siddiqui Rabih Maroun Michel Chalhoub |
| author_sort | Naureen Narula |
| collection | DOAJ |
| description | Indwelling Pleural Catheters (IPC) are increasingly being used for management of recurrent pleural effusions (RPEs). Use of IPC for management of both malignant and non-malignant recurrent pleural effusions has been associated with complications such as dysfunctional or nonfunctioning IPCs. Alteplase, a tissue plasminogen activator (tPA) is often used to restore flow of non-draining IPC in symptomatic patients.We present a case of a sixty-eight-year old patient with life-threatening pleural hemorrhage following intrapleural catheter instillation of tPA that was managed successfully by thoracotomy. Our case describe the importance of individualizing the fibrinolytic dose, frequency and the indwelling time in high risk patients. We have reviewed the current literature and recommendations for use of fibrinolytic therapy for IPC in high risk patients on anticoagulation. |
| first_indexed | 2024-12-22T01:37:00Z |
| format | Article |
| id | doaj.art-5ffd9bc535e749d087b2515816a49396 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-22T01:37:00Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-5ffd9bc535e749d087b2515816a493962022-12-21T18:43:20ZengElsevierRespiratory Medicine Case Reports2213-00712021-01-0134101420A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patientsNaureen Narula0Nakul Katyal1Mohammed Salem2Akshay Avula3Abdulhassan Siddiqui4Rabih Maroun5Michel Chalhoub6Department of Pulmonary and Critical Care, Staten Island University Hospital, Staten Island, NY, USA; Corresponding author.Department of Neurology, University of Missouri, Columbia, MO, USADepartment of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USADepartment of Pulmonary and Critical Care, Staten Island University Hospital, Staten Island, NY, USADepartment of Pulmonary and Critical Care, Christie Clinic, Champagne, Illinois, USADepartment of Pulmonary and Critical Care, Staten Island University Hospital, Staten Island, NY, USADepartment of Pulmonary and Critical Care, Staten Island University Hospital, Staten Island, NY, USAIndwelling Pleural Catheters (IPC) are increasingly being used for management of recurrent pleural effusions (RPEs). Use of IPC for management of both malignant and non-malignant recurrent pleural effusions has been associated with complications such as dysfunctional or nonfunctioning IPCs. Alteplase, a tissue plasminogen activator (tPA) is often used to restore flow of non-draining IPC in symptomatic patients.We present a case of a sixty-eight-year old patient with life-threatening pleural hemorrhage following intrapleural catheter instillation of tPA that was managed successfully by thoracotomy. Our case describe the importance of individualizing the fibrinolytic dose, frequency and the indwelling time in high risk patients. We have reviewed the current literature and recommendations for use of fibrinolytic therapy for IPC in high risk patients on anticoagulation.http://www.sciencedirect.com/science/article/pii/S2213007121000824Indwelling pleural catheters (IPCs)Recurrent pleural effusions (RPEs)HemothoraxMalignant pleural effusionsComplications |
| spellingShingle | Naureen Narula Nakul Katyal Mohammed Salem Akshay Avula Abdulhassan Siddiqui Rabih Maroun Michel Chalhoub A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients Respiratory Medicine Case Reports Indwelling pleural catheters (IPCs) Recurrent pleural effusions (RPEs) Hemothorax Malignant pleural effusions Complications |
| title | A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients |
| title_full | A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients |
| title_fullStr | A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients |
| title_full_unstemmed | A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients |
| title_short | A case of hemothorax secondary to intrapleural fibrinolytic therapy: Considerations for use of fibrinolytics in high-risk patients |
| title_sort | case of hemothorax secondary to intrapleural fibrinolytic therapy considerations for use of fibrinolytics in high risk patients |
| topic | Indwelling pleural catheters (IPCs) Recurrent pleural effusions (RPEs) Hemothorax Malignant pleural effusions Complications |
| url | http://www.sciencedirect.com/science/article/pii/S2213007121000824 |
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