[Long-term outcome of intrapleural fibrinolytic therapy via small-bore catheter drainage in the management of complicated parapneumonic effusion and empyema-a case series].
OBJECTIVE
Complicated parapneumonic effusions (PPE) and pleural empyemas (PE) are associated with increased morbidity and mortality. Intrapleural fibrinolytic therapy (IFT) has been established, besides video-assisted thoracoscopy (VATS), in the management of PPE and PE. Combination of IFT and small-bore catheter drainage has previously not been investigated.


METHODS
15 patients consecutively referred for PPE and PE were managed with simultaneous IFT via small-bore catheter drainage (9, 12, 14 F). In addition to evaluation of primary outcome, lung function testing and radiologic studies were obtained after 3 months to predict potential pulmonary restrictive impairment and residual pleural thickening.


RESULTS
Primary outcome of all 15 patients was positive. Only one patient showed a significant residual pleural thickening. None of the patients showed a restrictive lung function pattern.


CONCLUSIONS
Proven applicability of IFT via small-bore catheter drainage seems to be effective in the face of long-term outcome. Further prospective and multicentric studies should be initiated to investigate the practicability of IFT via small-bore catheter drainage.
Tasci
Selçuk
S
Medizinische Klinik und Poliklinik II, Universitätsklinikum, Bonn. Selcuk.Tasci@ukb.uni-bonn.de
Burghard
Alexandra
A
Schäfer
Harald
H
Rabe
Christian
C
Ewig
Santiago
S
Lüderitz
Berndt
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D004322:Drainage / Q000295:instrumentation*; D016724:Empyema, Pleural / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000008:administration & dosage*; D010996:Pleural Effusion / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011014:Pneumonia / Q000150:complications; D011379:Prognosis; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator