Fibrinolytic therapy for parapneumonic empyema during pregnancy

Ulutaş, Hakkı; Yekeler, Erdal; Sak, Zafer Hasan Ali; Doru, Ihsan; Kuzucu, Akın

doi:10.1016/j.rmedc.2011.08.005

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…IPFT was even used in 2 pregnant patients developing non-drainable parapneumonic empyema safely. No complications related to the existing local treatments were observed in the mothers or infants after delivery (15). There was no IPTF-related mortality in our study.…”

Section: Discussionmentioning

confidence: 43%

Intrapleural Fibrinolytic Treatment: Management of 85 Cases

Ulutaş¹,

Çelik²,

Kuzucu³

2015

J Turgut Ozal Med Cent

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Objective: Fibrous cortex developes over the lung in 7-10 days if the benign or malign pleural effusion consisting of blood, coagulum or empyema could not be drained. Thus, clinical conditions like trapped lung, restrictive lung disease, or dyspnea may appear as a result of fibrinous pleuritis. Both streptokinase and tissue plasminogen activator (tPA) are involved in the breakdown of proteins and fibrin. Hence, intrapleural fibrinolytic treatment (IPFT) may prevent invazive procedures by avoiding fibrous cortex develepment if it is applied at a proper time. Materials and Methods: Eighty five cases undergoing IPFT by tube or catheter thoracostomies between 2003-2013 are evaluated retrospectively. Patients have been evaluated according to age, symptoms, diagnosis, and response to treatment. Results: The mean age of the patients was 45.5 (65 males and 20 females). IPFT was performed in 30 patients with empyema, and in 20 and 13 patients due to postoperative or posttraumatic organised hematomas, respectively. Eleven patients underwent IPFT for loculated benign pleural effusions while 9 patients recieved the treatment for loculated malign pleural effusions. Complicated hydropneumothorax was the indication for IPFT in 2 patients. A total of sixty patients received tube thoracostomy while 25 patients underwent catheter thoracostomy. Tree patients had decortication and 4 underwent video assisted thoracoscopic (VATS) drainage due to failure of IPFT. Aseptic pleural space remained in 12 patients at the end of our study. One of the patients required blood transfusion and additional medical treatment for intrapleural hemorrhage secondary to the local absorption of the IPFT. Conclusion: IPFT is a safe, effective treatment which can be performed prior to much invasive surgical procedures in patients with loculated empyema, clotted hemothorax, or postoperative hematoma, and benign or malign pleural effusions which can not be drained due to high fibrinous contents. Key Words: Intrapleural; Streptokinase; Tissue Plasminogen Activator. İntraplevral Fibrinolitik Tedavi Uygulamaları: 85 Olguluk Seri SunumuÖzet: Amaç: Komplike plevral efüzyonlarda sadece tüp ve katater torakostomi ile sıvıyı drene etmek her zaman mümkün olmaz. Drene edilemeyen kan, pıhtı, ampiyem, benign veya malign plevral sıvılarda 7-10 gün içinde akciğer üzerinden fibröz bir kabuk oluşmaya başlar. Bu durum ise tuzaklanmış akciğer ve akciğer restriksiyonu, sekonder ampiyem ve dispne ile sonuçlanır. Streptokinaz yada Tissue Plazminojen Activatörü (tPA), fibrin ve diğer bazı proteinleri parçalayarak etki etmekte olup uygun zamanda yapılan fibrinolitik tedavi ile bu süreç kesintiye uğratılıp, akciğer üzerinde fibröz kabuk gelişimi önlenerek hasta daha invaziv işlemlerden kurtarılabilir. Gereç ve Yöntemler: Bu çalışmada 2003-2013 yılları arasında tüp yada kateter torakostomisi ile intraplevral fibrinolitik tedavi (IPFT) uygulanan 85 olgu retrospektif olarak incelendi. Olgular yaş, cinsiyet, semptom, tanı ve tedaviye yanıt açısından değerlendirildi. Bulgular: O...

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Section: Discussionmentioning

confidence: 43%

Intrapleural Fibrinolytic Treatment: Management of 85 Cases

Ulutaş¹,

Çelik²,

Kuzucu³

2015

J Turgut Ozal Med Cent

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“…The fibrinolytic activity found in the extracts of greater amberjack S. dumerili indicates the biotechnological potential of these neglected digestive wastes. Thrombolytic agents are used for thrombosis of the cardiac valve [29], in the enzymatic debridement of the pleural cavity [30], cancer therapy [31] and pathophysiological action in the nervous system [32]. To our knowledge, no record of fibrinolytic agents from fish processing residues has been reported to date; the present study was the first report.…”

Section: Discussionmentioning

confidence: 75%

Study on enzymes of industrial interest in digestive viscera: Greater amberjack (Seriola dumerili)

Oliveira¹,

Nascimento²,

Assis³

et al. 2017

JCLM

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“…It is associated with serious complications such as empyema (8%), bacteremia (16%), and respiratory failure (20%). The management of complicated parapneumonic effusion consist of antibiotics, chest tube insertion, and fibrinolytics or surgery [ 1 , 2 ]. The use of fibrinolytics had decreased the rate of surgical intervention for empyema from 80 to 30% [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The use of fibrinolytic therapy for parapneumonic effusion in pregnancy: a case report and a review

Nasralla

Laing

Turner

2021

J Cardiothorac Surg

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The use of intrapleural fibrinolytics for complicated parapneumonic effusion has been shown to be an effective and safe alternative to surgery. However, there is limited evidence about its use during pregnancy. We present a case and a review of the literature of pregnant women who had successful treatment of their complicated parapneumonic effusion with intrapleural fibrinolytics. To our knowledge this is the first review of cases of pregnant women with parapneumonic effusion managed with intrapleural fibrinolytic.

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Fibrinolytic therapy for parapneumonic empyema during pregnancy

Cited by 4 publications

References 10 publications

Intrapleural Fibrinolytic Treatment: Management of 85 Cases

Intrapleural Fibrinolytic Treatment: Management of 85 Cases

Study on enzymes of industrial interest in digestive viscera: Greater amberjack (Seriola dumerili)

The use of fibrinolytic therapy for parapneumonic effusion in pregnancy: a case report and a review

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