ERJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Permissions
Right arrowRequest Permissions
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bouros, D
Right arrow Articles by Siafakas, N
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bouros, D
Right arrow Articles by Siafakas, N
Eur Respir J 1996; 9: 1656-1659
Copyright © ERS Journals Ltd 1996


Clinical Trial

Intrapleural urokinase in the treatment of complicated parapneumonic pleural effusions and empyema

D Bouros, S Schiza, N Tzanakis, J Drositis, and N Siafakas

Intrapleural urokinase has not been evaluated systemically in terms of efficacy, safety, and cost of treatment in a large series of patients with complicated (parapneumonic) pleural effusions (CPE) and pleural empyemas (PE). Furthermore, the optimal dose and duration of treatment is not known. Twenty consecutive patients with multiloculated parapneumonic effusions (13 with CPE and 7 with PE), in whom a single chest tube failed to drain the fluid, were studied prospectively. The age of the patients ranged 15-92 yrs (median 51 yrs). Urokinase was administered intrapleurally, in a low single daily dose of 50,000 U in 100 mL normal saline via the chest tube. Previous intrapleural instillation of 100 mL normal saline failed to promote drainage in all patients. Urokinase enhanced drainage in all patients. Clinical and radiological improvement was noted in all but one patient. The mean (SD) volume of fluid significantly increased in the first 24 h post-urokinase (p<0.001). The number of urokinase instillations ranged 3-7 (median 5). Radiological evaluation showed excellent improvement in 13 of the 20 (65%) patients. Urokinase was well-tolerated in all patients. The clinical course of patients was uneventful at a mean follow-up of 15 months (range 6-30 months) later. Mean total cost of treatment was $530 +/- 34.6. Our results show that intrapleural instillation of small doses of urokinase is a cost-effective and safe mode of treatment of complicated pleural effusions and pleural empyema and could be the fibrinolytic of choice.


This article has been cited by other articles:


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
A. A. Komissarov, A. P. Mazar, K. Koenig, A. K. Kurdowska, and S. Idell
Regulation of intrapleural fibrinolysis by urokinase-{alpha}-macroglobulin complexes in tetracycline-induced pleural injury in rabbits
Am J Physiol Lung Cell Mol Physiol, October 1, 2009; 297(4): L568 - L577.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
C.-H. Chen, W.-H. Hsu, H.-J. Chen, W. Chen, C.-M. Shih, T.-C. Hsia, and C.-Y. Tu
Different Bacteriology and Prognosis of Thoracic Empyemas Between Patients With Chronic and End-Stage Renal Disease
Chest, August 1, 2007; 132(2): 532 - 539.
[Abstract] [Full Text] [PDF]


Home page
Mayo Clin Proc.Home page
G. M. Levinson and D. W. Pennington
Intrapleural Fibrinolytics Combined With Image-Guided Chest Tube Drainage for Pleural Infection
Mayo Clin. Proc., April 1, 2007; 82(4): 407 - 413.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
S. Idell, T. Allen, S. Chen, K. Koenig, A. Mazar, and A. Azghani
Intrapleural activation, processing, efficacy, and duration of protection of single-chain urokinase in evolving tetracycline-induced pleural injury in rabbits
Am J Physiol Lung Cell Mol Physiol, January 1, 2007; 292(1): L25 - L32.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
G. Ekingen, B. H. Guvenc, S. Sozubir, A. Tuzlaci, and U. Senel
Fibrinolytic treatment of complicated pediatric thoracic empyemas with intrapleural streptokinase
Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 503 - 507.
[Abstract] [Full Text] [PDF]


Home page
ThoraxHome page
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]


Home page
The Annals of PharmacotherapyHome page
C. A Walker, M. B. Shirk, M. M Tschampel, and J. A Visconti
Intrapleural Alteplase in a Patient with Complicated Pleural Effusion
Ann. Pharmacother., March 1, 2003; 37(3): 376 - 379.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
H.-C. Huang, H.-Y. Chang, C.-W. Chen, C.-H. Lee, and T.-R. Hsiue
Predicting Factors for Outcome of Tube Thoracostomy in Complicated Parapneumonic Effusion or Empyema
Chest, March 1, 1999; 115(3): 751 - 756.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Respir. Crit. Care Med.Home page
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]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the European Respiratory Society.