Abstract
Purpose
We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas.
Methods
Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven.
Results
As compared with patients only receiving urokinase, those additionally treated with saline flushing needed less fibrinolytic doses (a single dose being sufficient in 15 vs 44%, p = 0.019), chest tube duration (5 vs 2 days, p < 0.01), and length of hospital stay (8 vs 6 days, p = 0.011). There were no adverse events attributed to saline therapy.
Conclusions
Manual pleural saline flushing via chest tube, in addition to urokinase, is a safe and potentially beneficial therapy in patients with pleural infection.
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None of the authors has any conflict of interest to declare in relation to this work.
Ethical Approval
All studies performed in human participants were in accordance with the ethical standards of the institutional research committee and with the Helsinki declaration.
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Porcel, J.M., Valencia, H. & Bielsa, S. Manual Intrapleural Saline Flushing Plus Urokinase: A Potentially Useful Therapy for Complicated Parapneumonic Effusions and Empyemas. Lung 195, 135–138 (2017). https://doi.org/10.1007/s00408-016-9964-2
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DOI: https://doi.org/10.1007/s00408-016-9964-2