Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion
Background Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose u...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Academy of Tuberculosis and Respiratory Diseases
2021-04-01
|
| Series: | Tuberculosis and Respiratory Diseases |
| Subjects: | |
| Online Access: | http://www.e-trd.org/upload/pdf/trd-2020-0018.pdf |
| _version_ | 1818727219404472320 |
|---|---|
| author | Seul Lee Heock Lee Dong Hyun Lee Bo Hyoung Kang Mee Sook Roh Choohee Son Sung Hyun Kim Hyun-Kyung Lee Soo-Jung Um |
| author_facet | Seul Lee Heock Lee Dong Hyun Lee Bo Hyoung Kang Mee Sook Roh Choohee Son Sung Hyun Kim Hyun-Kyung Lee Soo-Jung Um |
| author_sort | Seul Lee |
| collection | DOAJ |
| description | Background Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema. |
| first_indexed | 2024-12-17T22:10:37Z |
| format | Article |
| id | doaj.art-a100358a01564f78a62f352536b2da6d |
| institution | Directory Open Access Journal |
| issn | 1738-3536 2005-6184 |
| language | English |
| last_indexed | 2024-12-17T22:10:37Z |
| publishDate | 2021-04-01 |
| publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
| record_format | Article |
| series | Tuberculosis and Respiratory Diseases |
| spelling | doaj.art-a100358a01564f78a62f352536b2da6d2022-12-21T21:30:45ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842021-04-0184213413910.4046/trd.2020.00183294Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic EffusionSeul Lee0Heock Lee1Dong Hyun Lee2Bo Hyoung Kang3Mee Sook Roh4Choohee Son5Sung Hyun Kim6Hyun-Kyung Lee7Soo-Jung Um8 Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Department of Pathology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of KoreaBackground Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.http://www.e-trd.org/upload/pdf/trd-2020-0018.pdfcathetersempyemafibrinolysisindwellingpleurisypneumonia |
| spellingShingle | Seul Lee Heock Lee Dong Hyun Lee Bo Hyoung Kang Mee Sook Roh Choohee Son Sung Hyun Kim Hyun-Kyung Lee Soo-Jung Um Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion Tuberculosis and Respiratory Diseases catheters empyema fibrinolysis indwelling pleurisy pneumonia |
| title | Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion |
| title_full | Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion |
| title_fullStr | Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion |
| title_full_unstemmed | Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion |
| title_short | Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion |
| title_sort | fibrinolysis with lower dose urokinase in patients with complicated parapneumonic effusion |
| topic | catheters empyema fibrinolysis indwelling pleurisy pneumonia |
| url | http://www.e-trd.org/upload/pdf/trd-2020-0018.pdf |
| work_keys_str_mv | AT seullee fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT heocklee fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT donghyunlee fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT bohyoungkang fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT meesookroh fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT chooheeson fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT sunghyunkim fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT hyunkyunglee fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion AT soojungum fibrinolysiswithlowerdoseurokinaseinpatientswithcomplicatedparapneumoniceffusion |