Literature DB >> 27866276

Manual Intrapleural Saline Flushing Plus Urokinase: A Potentially Useful Therapy for Complicated Parapneumonic Effusions and Empyemas.

José M Porcel1, Horacio Valencia2, Silvia Bielsa2.   

Abstract

PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas.
METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven.
RESULTS: As compared with patients only receiving urokinase, those additionally treated with saline flushing needed less fibrinolytic doses (a single dose being sufficient in 15 vs 44%, p = 0.019), chest tube duration (5 vs 2 days, p < 0.01), and length of hospital stay (8 vs 6 days, p = 0.011). There were no adverse events attributed to saline therapy.
CONCLUSIONS: Manual pleural saline flushing via chest tube, in addition to urokinase, is a safe and potentially beneficial therapy in patients with pleural infection.

Entities:  

Keywords:  Empyema; Parapneumonic effusion; Saline; Urokinase

Mesh:

Substances:

Year:  2016        PMID: 27866276     DOI: 10.1007/s00408-016-9964-2

Source DB:  PubMed          Journal:  Lung        ISSN: 0341-2040            Impact factor:   2.584


  10 in total

Review 1.  Pleural effusions.

Authors:  José M Porcel; Richard W Light
Journal:  Dis Mon       Date:  2013-02       Impact factor: 3.800

2.  Predictive factors, microbiology and outcome of patients with parapneumonic effusion.

Authors:  M Falguera; J Carratalà; S Bielsa; C García-Vidal; A Ruiz-González; I Chica; F Gudiol; J M Porcel
Journal:  Eur Respir J       Date:  2011-05-12       Impact factor: 16.671

Review 3.  Efficacy of intrapleural instillation of fibrinolytics for treating pleural empyema and parapneumonic effusion: a meta-analysis of randomized control trials.

Authors:  Wencheng Nie; Yanru Liu; Jian Ye; Liuhong Shi; Fangchun Shao; Kejing Ying; Ruifeng Zhang
Journal:  Clin Respir J       Date:  2014-01-16       Impact factor: 2.570

4.  Intrapleural Fibrinolysis with Urokinase Versus Alteplase in Complicated Parapneumonic Pleural Effusions and Empyemas: A Prospective Randomized Study.

Authors:  Carmen Alemán; José M Porcel; José Alegre; Eva Ruiz; Silvia Bielsa; Jordi Andreu; Maria Deu; Pilar Suñé; Mireia Martínez-Sogués; Iker López; Esther Pallisa; Joan Antoni Schoenenberger; J Bruno Montoro; Tomás Fernández de Sevilla
Journal:  Lung       Date:  2015-09-30       Impact factor: 2.584

Review 5.  Intrapleural fibrinolytic therapy for treatment of adult parapneumonic effusions and empyemas: a systematic review and meta-analysis.

Authors:  Surinder Janda; John Swiston
Journal:  Chest       Date:  2012-08       Impact factor: 9.410

6.  Pleural irrigation trial (PIT): a randomised controlled trial of pleural irrigation with normal saline versus standard care in patients with pleural infection.

Authors:  Clare E Hooper; Anthony J Edey; Anthony Wallis; Amelia O Clive; Anna Morley; Paul White; Andrew R L Medford; John E Harvey; Mike Darby; Natalie Zahan-Evans; Nick A Maskell
Journal:  Eur Respir J       Date:  2015-05-28       Impact factor: 16.671

7.  Tissue plasminogen activator potently stimulates pleural effusion via a monocyte chemotactic protein-1-dependent mechanism.

Authors:  Sally M Lansley; Hui Min Cheah; Julius F Varano Della Vergiliana; Aron Chakera; Y C Gary Lee
Journal:  Am J Respir Cell Mol Biol       Date:  2015-07       Impact factor: 6.914

8.  Intrapleural use of tissue plasminogen activator and DNase in pleural infection.

Authors:  Najib M Rahman; Nicholas A Maskell; Alex West; Richard Teoh; Anthony Arnold; Carolyn Mackinlay; Daniel Peckham; Chris W H Davies; Nabeel Ali; William Kinnear; Andrew Bentley; Brennan C Kahan; John M Wrightson; Helen E Davies; Clare E Hooper; Y C Gary Lee; Emma L Hedley; Nicky Crosthwaite; Louise Choo; Emma J Helm; Fergus V Gleeson; Andrew J Nunn; Robert J O Davies
Journal:  N Engl J Med       Date:  2011-08-11       Impact factor: 91.245

9.  U.K. Controlled trial of intrapleural streptokinase for pleural infection.

Authors:  Nicholas A Maskell; Christopher W H Davies; Andrew J Nunn; Emma L Hedley; Fergus V Gleeson; Robert Miller; Rhian Gabe; Glyn L Rees; Timothy E A Peto; Mark A Woodhead; Donald J Lane; Janet H Darbyshire; Robert J O Davies
Journal:  N Engl J Med       Date:  2005-03-03       Impact factor: 91.245

10.  A clinical score (RAPID) to identify those at risk for poor outcome at presentation in patients with pleural infection.

Authors:  Najib M Rahman; Brennan C Kahan; Robert F Miller; Fergus V Gleeson; Andrew J Nunn; Nicholas A Maskell
Journal:  Chest       Date:  2014-04       Impact factor: 9.410

  10 in total
  4 in total

Review 1.  Infectious pleural effusion status and treatment progress.

Authors:  Wei Yang; Bo Zhang; Ze-Ming Zhang
Journal:  J Thorac Dis       Date:  2017-11       Impact factor: 2.895

2.  A systematic review of comorbidities and outcomes of adult patients with pleural infection.

Authors:  Tamsin N Cargill; Maged Hassan; John P Corcoran; Elinor Harriss; Rachelle Asciak; Rachel M Mercer; David J McCracken; Eihab O Bedawi; Najib M Rahman
Journal:  Eur Respir J       Date:  2019-10-01       Impact factor: 16.671

3.  Two vs. three weeks of treatment with amoxicillin-clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial.

Authors:  José M Porcel; Lucia Ferreiro; Laura Rumi; Esther Espino-Paisán; Carmen Civit; Marina Pardina; Juan Antonio Schoenenberger-Arnaiz; Luis Valdés; Silvia Bielsa
Journal:  Pleura Peritoneum       Date:  2020-02-26

Review 4.  Recent Insights into the Management of Pleural Infection.

Authors:  Maged Hassan; Shefaly Patel; Ahmed S Sadaka; Eihab O Bedawi; John P Corcoran; José M Porcel
Journal:  Int J Gen Med       Date:  2021-07-14
  4 in total

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