title: Intrapleural administration of DNase alone for pleural empyema.
abstract: BACKGROUND
  Pleural empyema is a severe complication of various diseases. The essential is the inserting a drain into the pleural cavity and evacuation of the pus. Sometimes the pus is very thick and its evacuation and re-expansion of the lung is very difficult.
  
  
  METHODS
  We report a group of 10 patients with intrapleural administration of Pulmozyme (dornase alpha) in dosages of either 2.5 mg once or on two separate occasions. All of the patients had a chest tube inserted into the pleural cavity. Measurement of viscosity was done before and after the instillation of the dornase alpha.
  
  
  RESULTS
  In six patients dornase alfa was introduced into the pleural cavity once. Three of them received this on the 4th whilst the rest were treated with the agent on the 6th day. Four patients received the dornase alpha twice because of the small amount of drainage fluid after the previous instillation. Five patients were discharged from hospital with complete re-expansion of their lungs. Two patients were qualified for a surgical operation since the lung was trapped and did not re-expand. Three patients had to be discharged with a drain as a result of incomplete re-expansion of the lung. In all the patients the density of the pus after administering the dornase alpha decreased and the amount of the pus drainage increased.
  
  
  CONCLUSIONS
  Dornase alpha may be used in some patients with pleural empyema with good results.
authors.affiliation: Department of Laboratory Genetics, University Hospital Kralovske VinohradyPrague, Czech Republic; Department of Histology and Embryology, Wroclaw Medical UniversityWrocław, Poland; 3rd Department of Surgery, First Faculty of Medicine Charles University in Prague and University Hospital MotolCzech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bobek
authors.affiliation: Department of Thoracic Surgery, Nottingham City Hospital Nottingham, UK.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Majewski
authors.affiliation: Department of Laboratory Genetics, University Hospital Kralovske Vinohrady Prague, Czech Republic.
authors.forename: Katarina
authors.initials: K
authors.lastname: Kolostova
authors.affiliation: Department of Thoracic Surgery, Wroclaw Medical UniversityWroclaw, Poland; Wroclaw Thoracic Surgery Centre, Lower Silesian Centre of Lung DiseasesWroclaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Rzechonek
authors.affiliation: 3rd Department of Surgery, First Faculty of Medicine Charles University in Prague and University Hospital Motol Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Lischke
authors.affiliation: 3rd Department of Surgery, First Faculty of Medicine Charles University in Prague and University Hospital Motol Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Schutzner
authors.affiliation: Department of Thoracic Surgery, Wroclaw Medical University Wroclaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kacprzak
keywords: DNase; Pleural empyema; deoxyribonuclease; dornase alpha; lung; pulmozyme; viscosity