Successful management of pleural infection with very low dose intrapleural tissue plasminogen activator/deoxyribonuclease regime

Jodi Andrea Hart, Arash Badiei, Y. C. Gary Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Pleural infection managed with intrapleural therapy using a combination of 10 mg of tissue plasminogen activator (tPA) and 5 mg of deoxyribonuclease (DNase) has been shown in randomized and open-label studies to successfully treat >90% of patients without resorting to surgery. Potential bleeding risks, although low, and costs associated with tPA remain important concerns. No phase I studies exist for intrapleural tPA therapy and the lowest effective dose has not been established. In patients with high bleeding risks, lower doses may present a safer alternative. We report a case of a complex parapneumonic effusion in a patient with coagulopathy that was successfully treated with a very low dose tPA (1 mg) and DNase (5 mg) regime.

Original languageEnglish
Article number00408
Number of pages3
JournalRespirology Case Reports
Volume7
Issue number3
DOIs
Publication statusPublished - Apr 2019

Cite this

@article{7cdc7c2a3c0c4fafbd9a1ed5c06a0cb2,
title = "Successful management of pleural infection with very low dose intrapleural tissue plasminogen activator/deoxyribonuclease regime",
abstract = "Pleural infection managed with intrapleural therapy using a combination of 10 mg of tissue plasminogen activator (tPA) and 5 mg of deoxyribonuclease (DNase) has been shown in randomized and open-label studies to successfully treat >90{\%} of patients without resorting to surgery. Potential bleeding risks, although low, and costs associated with tPA remain important concerns. No phase I studies exist for intrapleural tPA therapy and the lowest effective dose has not been established. In patients with high bleeding risks, lower doses may present a safer alternative. We report a case of a complex parapneumonic effusion in a patient with coagulopathy that was successfully treated with a very low dose tPA (1 mg) and DNase (5 mg) regime.",
keywords = "Deoxyribonuclease, empyema, fibrinolytic, pleural effusion, pleural infection, ACTIVATOR, ALTEPLASE",
author = "Hart, {Jodi Andrea} and Arash Badiei and Lee, {Y. C. Gary}",
year = "2019",
month = "4",
doi = "10.1002/rcr2.408",
language = "English",
volume = "7",
journal = "Respirology Case Reports",
issn = "2051-3380",
publisher = "John Wiley & Sons",
number = "3",

}

Successful management of pleural infection with very low dose intrapleural tissue plasminogen activator/deoxyribonuclease regime. / Hart, Jodi Andrea; Badiei, Arash; Lee, Y. C. Gary.

In: Respirology Case Reports, Vol. 7, No. 3, 00408, 04.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Successful management of pleural infection with very low dose intrapleural tissue plasminogen activator/deoxyribonuclease regime

AU - Hart, Jodi Andrea

AU - Badiei, Arash

AU - Lee, Y. C. Gary

PY - 2019/4

Y1 - 2019/4

N2 - Pleural infection managed with intrapleural therapy using a combination of 10 mg of tissue plasminogen activator (tPA) and 5 mg of deoxyribonuclease (DNase) has been shown in randomized and open-label studies to successfully treat >90% of patients without resorting to surgery. Potential bleeding risks, although low, and costs associated with tPA remain important concerns. No phase I studies exist for intrapleural tPA therapy and the lowest effective dose has not been established. In patients with high bleeding risks, lower doses may present a safer alternative. We report a case of a complex parapneumonic effusion in a patient with coagulopathy that was successfully treated with a very low dose tPA (1 mg) and DNase (5 mg) regime.

AB - Pleural infection managed with intrapleural therapy using a combination of 10 mg of tissue plasminogen activator (tPA) and 5 mg of deoxyribonuclease (DNase) has been shown in randomized and open-label studies to successfully treat >90% of patients without resorting to surgery. Potential bleeding risks, although low, and costs associated with tPA remain important concerns. No phase I studies exist for intrapleural tPA therapy and the lowest effective dose has not been established. In patients with high bleeding risks, lower doses may present a safer alternative. We report a case of a complex parapneumonic effusion in a patient with coagulopathy that was successfully treated with a very low dose tPA (1 mg) and DNase (5 mg) regime.

KW - Deoxyribonuclease

KW - empyema

KW - fibrinolytic

KW - pleural effusion

KW - pleural infection

KW - ACTIVATOR

KW - ALTEPLASE

U2 - 10.1002/rcr2.408

DO - 10.1002/rcr2.408

M3 - Article

VL - 7

JO - Respirology Case Reports

JF - Respirology Case Reports

SN - 2051-3380

IS - 3

M1 - 00408

ER -