title: Tissue plasminogen activator as an adjuvant therapy for pleural empyema in pediatric patients.
abstract: The authors retrospectively review the clinical course and outcome of 6 pediatric patients, ranging in age from 2 to 13 years, who were treated with TPA for complex empyema. Efficacy was assessed by evaluating pleural fluid drainage for 6 hours prior to and subsequent to each dose of TPA, as well as by resolution of fever and length of hospital stay. The average volume drained for 6 hours before infusion of TPA was 22.5 mL +/- 18.4 mL, and the average volume 6 hours after TPA therapy was 141.7 mL +/- 28.3 mL, P <.0001. After initiation of TPA therapy, 5 out of 6 patients became afebrile within 48 hours. The median length of stay after initiation of TPA therapy was 6 days, with a range from 4 days to 12 days. A discussion of other current therapies for empyema, along with a comparison of these therapies to TPA regarding the costs of therapies and risk-benefit ratios, is also included.
authors.affiliation: Department of Child Health, The University of Missouri, Columbia, MO 65212, USA.
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Ray
authors.forename: John W
authors.initials: JW
authors.lastname: Berkenbosch
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Russo
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D016724:Empyema, Pleural / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D013300:Streptokinase / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator