Case reportIntrapleural instillation of urokinase in the treatment of loculated pleural effusions in children
References (11)
- et al.
CT and ultrasound guided catheter drainage of empyemas after chest tube failure
Radiology
(1984) - et al.
Radiographically guided percutaneous catheter drainage of pleural fluid collections
AJR
(1988) - et al.
Acquired lesions of the lung and pleura
- et al.
Safety of intracavitary urokinase with percutaneous abscess drainage
AJR
(1993) - et al.
Fibrin in peritonitis: The mechanism of bacterial trapping in polymerized fibrin
Surgery
(1982)
Cited by (44)
The diagnosis and management of empyema in children: A comprehensive review from the APSA outcomes and clinical trials committee
2012, Journal of Pediatric SurgeryCitation Excerpt :The common examples are urokinase, streptokinase and tissue plasminogen activator (tPA). Since fibrin is a predominant component of the extracellular matrix upon which septations and solid debris form, instillation of a fibrinolytic agent to liquefy pleural space disease has been shown to be effective in promoting resolution of empyema in multiple studies [39,40,44-63]. Fibrinolysis has been shown to be superior to chest tube drainage alone in retrospective and prospective studies, by both direct comparison and when used in patients who failed chest tube drainage only [44-46,50,53-55,58,61,63].
Treatment of loculated parapneumonic empyema. Video assisted thoracoscopy or fibrinolytics?
2011, Anales de PediatriaEvaluation of a pediatric protocol of intrapleural urokinase for pleural empyema: A prospective study
2010, SurgeryCitation Excerpt :Although several small trials suggested that intrapleural urokinase and streptokinase could increase the amount of fluid drained and improve outcome in adults,17,18 a recent meta-analysis showed that there is not sufficient evidence to recommend the routine use of fibrinolytics,14 and a large-scale, multicenter, randomized trial (MIST1) failed to confirm any benefits of intrapleural streptokinase versus normal saline.19 The use of fibrinolytics in children with empyema has first been described by Rosen et al in 199320; several other authors have reported successful treatment of childhood empyema with instillation of either streptokinase or urokinase.7,21-23 However, streptokinase is of bacterial origin, and several undesired effects have been reported including fever, allergic reactions, and significant anti-streptokinase antibody production.19,20,24
Pulmonary decortication: Value of lung function recovery
2009, Revue de Pneumologie CliniquePLEURAL EFFUSIONS AND EMPYEMA
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth EditionThoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial
2009, Journal of Pediatric SurgeryCitation Excerpt :At the time this study was developed and initiated, there were no published prospective trials comparing intrapleural fibrinolysis to thoracoscopic debridement for empyema. There were an abundance of data on the use of fibrinolysis in children to facilitate earlier resolution of empyema [8-23]. A review on the therapeutic options for empyema in children was published shortly before we began this study that concluded with the statement that a prospective, randomized trial comparing VATS to intrapleural fibrinolytic therapy was needed [24].