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Who is at risk for tPA/DNase treatment failure in empyema?-protocol to identify key predictors for early surgical intervention from a retrospective study.
J Thorac Dis
December 2024
Critical Care Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA.
Background: Empyema, characterized by the accumulation of pus in the pleural cavity, poses significant treatment challenges. While intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy is effective for many patients, a substantial proportion require surgical intervention, such as video-assisted thoracoscopic surgery (VATS), following treatment failure. Identifying tPA/DNase treatment failure-associated predictors is crucial for optimizing patient management and improving outcomes.
View Article and Find Full Text PDFMedical thoracoscopy combined with intrapleural injection of urokinase for treatment of pleural infection-a multicenter, prospective, randomized controlled study: study protocol.
Respir Res
January 2025
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Pleural diseases is a common respiratory disorder, mainly characterized as pleural effusion and patients with pleural effusion caused by pneumonia and empyema constituted 29% of the cohort, which suggests pleural infection as the predominant etiology of pleural effusion in China. Medical thoracoscopy (MT) combined with intrapleural injection of Urokinase holds significant therapeutic value for patients with early to moderate-stage empyema. However, there remains a lack of high-quality evidence regarding the efficacy and safety of combining MT with intrapleural injection of Urokinase administration in patients with pleural infections.
View Article and Find Full Text PDFIntrapleural fibrinolytic therapy for pleural infections: Outcomes from a cohort study.
Ann Acad Med Singap
December 2024
Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
Introduction: Pleural infections are a significant cause of mortality. Intrapleural fibrinolytic therapy (IPFT) utilising alteplase and dornase is a treatment option for patients unsuitable for surgery. The optimal dose of alteplase is unknown, and factors affecting treatment success in an Asian population are unclear.
View Article and Find Full Text PDFRegional anesthesia modalities in blunt thoracic trauma: A systematic review and Bayesian network meta-analysis.
Am J Emerg Med
December 2024
Department of Anesthesia and Intensive care, University of Pisa, Pisa, Italy.
Background: Various regional anesthesia techniques have been studied for blunt chest wall trauma over the past decades, but their impact on patient outcomes remains unclear. This systematic review and Bayesian network meta-analysis aimed to identify the most effective regional anesthesia techniques for different outcomes in blunt thoracic trauma patients.
Methods: We searched Medline, EMBASE, Scopus, and Cochrane databases for randomized controlled trials comparing regional anesthesia techniques (thoracic epidural, erector spinae plane block, serratus anterior plane block, intercostal block, paravertebral block, intrapleural block, retrolaminar block) and standard intravenous analgesia.
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