A Retrospective Cohort Study Evaluating the Safety and Efficacy of Sequential versus Concurrent Intrapleural Instillation of Tissue Plasminogen Activator and DNase for Pleural Infection.

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  • Additional Information
    • Source:
      Publisher: Hindawi Pub. Corp Country of Publication: Egypt NLM ID: 101558762 Publication Model: eCollection Cited Medium: Internet ISSN: 2090-1844 (Electronic) Linking ISSN: 20901844 NLM ISO Abbreviation: Pulm Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: Cairo : Hindawi Pub. Corp.
    • Subject Terms:
      Pleural Diseases*/therapy ; Tissue Plasminogen Activator*/therapeutic use ; Deoxyribonucleases*/therapeutic use; Retrospective Studies ; Cohort Studies ; Humans ; Male ; Female ; Middle Aged ; Aged ; Treatment Outcome ; Fibrinolytic Agents/therapeutic use ; Pleural Effusion/therapy
    • Abstract:
      Methods: We conducted a retrospective review of patients with pleural infection requiring intrapleural therapy at two tertiary referral centres.
      Results: We included 84 (62.2%) and 51 (37.8%) patients who received sequential and concurrent intrapleural therapy, respectively. Patient demographics and clinical characteristics, including age, RAPID score, and percentage of pleural opacity on radiographs before intrapleural therapy, were similar in both groups. Treatment failure rates (defined by either in-hospital mortality, surgical intervention, or 30-day readmission for pleural infection) were 9.5% and 5.9% with sequential and concurrent intrapleural therapy, respectively ( p = 0.534). This translates to a treatment success rate of 90.5% and 94.1% for sequential and concurrent intrapleural therapy, respectively. There was no significant difference in the decrease in percentage of pleural effusion size on chest radiographs (15.1% [IQR 6-35.7] versus 26.6% [IQR 9.9-38.7], p = 0.143) between sequential and concurrent therapy, respectively. There were also no significant differences in the rate of pleural bleeding (4.8% versus 9.8%, p = 0.298) and chest pain (13.1% versus 9.8%, p = 0.566) between sequential and concurrent therapy, respectively.
      Conclusion: Our study adds to the growing literature on the safety and efficacy of concurrent intrapleural therapy in pleural infection.
      Competing Interests: The authors declare that they have no conflicts of interest.
      (Copyright © 2023 Ken Junyang Goh et al.)
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    • Accession Number:
      EC 3.4.21.68 (Tissue Plasminogen Activator)
      EC 3.1.- (Deoxyribonucleases)
      0 (Fibrinolytic Agents)
    • Publication Date:
      Date Created: 20231226 Date Completed: 20240220 Latest Revision: 20240220
    • Publication Date:
      20240220
    • Accession Number:
      PMC10749719
    • Accession Number:
      10.1155/2023/6340851
    • Accession Number:
      38146504