Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study
Abstract Objective The use of intrapleural tissue plasminogen activator (tPA) and dornase alfa (DNase) is common in the management of pleural space infection. We review our experience with the efficacy and safety of this therapy. We performed a single center, retrospective study of consecutive patie...
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Research Notes |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13104-020-05210-2 |
| _version_ | 1818517151434145792 |
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| author | Chuan Jiang Meng Xie Kelly Cervellione Craig Thurm |
| author_facet | Chuan Jiang Meng Xie Kelly Cervellione Craig Thurm |
| author_sort | Chuan Jiang |
| collection | DOAJ |
| description | Abstract Objective The use of intrapleural tissue plasminogen activator (tPA) and dornase alfa (DNase) is common in the management of pleural space infection. We review our experience with the efficacy and safety of this therapy. We performed a single center, retrospective study of consecutive patients with complicated parapneumonic effusion or empyema who received tPA/DNase therapy. Treatment success was defined as radiographic and clinical improvement in pleural space infection that precluded the need for surgical intervention, and the absence of mortality related to pleural infection. Results Fifty-six patients received concurrent once daily tPA/DNase therapy (median 3 days) from July 2014 to July 2019. Fifty-two patients (92.9%) had treatment success. Median duration of chest tube therapy was 10 days and length of stay was 15 days. Significant pleural bleeding requiring transfusion therapy occurred in five patients (8.9%). Of these, three patients (5.4%) required operative intervention. Concurrent once daily administration of tPA/DNase in patients with pleural infection yielded comparable rates of treatment success as compared to twice daily concurrent or sequential administration. However, adverse events highlight potential safety concerns with using once daily concurrent administration of tPA/DNAse. |
| first_indexed | 2024-12-11T00:52:19Z |
| format | Article |
| id | doaj.art-cc102d85ca934f44807852413f508580 |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-11T00:52:19Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-cc102d85ca934f44807852413f5085802022-12-22T01:26:35ZengBMCBMC Research Notes1756-05002020-08-011311610.1186/s13104-020-05210-2Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort studyChuan Jiang0Meng Xie1Kelly Cervellione2Craig Thurm3Department of Medicine-Division of Pulmonary Medicine, Jamaica Hospital Medical CenterDepartment of Clinical Research, Jamaica Hospital Medical CenterDepartment of Clinical Research, Jamaica Hospital Medical CenterDepartment of Medicine-Division of Pulmonary Medicine, Jamaica Hospital Medical CenterAbstract Objective The use of intrapleural tissue plasminogen activator (tPA) and dornase alfa (DNase) is common in the management of pleural space infection. We review our experience with the efficacy and safety of this therapy. We performed a single center, retrospective study of consecutive patients with complicated parapneumonic effusion or empyema who received tPA/DNase therapy. Treatment success was defined as radiographic and clinical improvement in pleural space infection that precluded the need for surgical intervention, and the absence of mortality related to pleural infection. Results Fifty-six patients received concurrent once daily tPA/DNase therapy (median 3 days) from July 2014 to July 2019. Fifty-two patients (92.9%) had treatment success. Median duration of chest tube therapy was 10 days and length of stay was 15 days. Significant pleural bleeding requiring transfusion therapy occurred in five patients (8.9%). Of these, three patients (5.4%) required operative intervention. Concurrent once daily administration of tPA/DNase in patients with pleural infection yielded comparable rates of treatment success as compared to twice daily concurrent or sequential administration. However, adverse events highlight potential safety concerns with using once daily concurrent administration of tPA/DNAse.http://link.springer.com/article/10.1186/s13104-020-05210-2Parapneumonic effusionEmpyemaFibrinolytic therapyPleural disease |
| spellingShingle | Chuan Jiang Meng Xie Kelly Cervellione Craig Thurm Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study BMC Research Notes Parapneumonic effusion Empyema Fibrinolytic therapy Pleural disease |
| title | Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study |
| title_full | Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study |
| title_fullStr | Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study |
| title_full_unstemmed | Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study |
| title_short | Clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration: a retrospective cohort study |
| title_sort | clinical efficacy and bleeding outcomes of tissue plasminogen activator and dornase alfa in pleural space infection with once daily concurrent administration a retrospective cohort study |
| topic | Parapneumonic effusion Empyema Fibrinolytic therapy Pleural disease |
| url | http://link.springer.com/article/10.1186/s13104-020-05210-2 |
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