Abstract | OBJECTIVE: To compare the efficacy of adjunctive intrapleural streptokinase (SK) with simple closed chest tube drainage (Drain) in the treatment of empyemas and complicated parapneumonic effusions. METHOD: This was a controlled study of 52 patients (mean age, 57 years; 41 men) with pleura space sepsis. Forty patients (77%) had empyema and 12 had complicated parapneumonic effusions. Twenty-nine patients were treated with Drain only while 23 received, in addition, repeated daily SK, 250,000 U in saline solution (mean, 5.3 days). RESULTS: The two groups of patients had comparable degrees of peripheral blood leukocytosis, frequency of loculated effusions, pleural fluid pH, and lactate dehydrogenase levels. Infective organisms were isolated in 54% of which 32% were anaerobic and 21% were polymicrobial infections. The incidence of surgical decortication was 17% and mortality was 15%. A significantly larger volume of pleural fluid was drained from patients in the SK treatment group (2.0 [1.5] L) than those in the Drain treatment group (1.0 [1.01] L). There were no significant differences, however, between the two treatment groups in terms of duration before defervescence, duration of hospital stay, the need for surgical intervention, or mortality rates. CONCLUSION:
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Authors | N K Chin, T K Lim |
Journal | Chest
(Chest)
Vol. 111
Issue 2
Pg. 275-9
(Feb 1997)
ISSN: 0012-3692 [Print] United States |
PMID | 9041968
(Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)
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Chemical References |
- Fibrinolytic Agents
- Streptokinase
|
Topics |
- Adult
- Drainage
- Empyema, Pleural
(drug therapy, therapy)
- Female
- Fibrinolytic Agents
(therapeutic use)
- Humans
- Male
- Middle Aged
- Pleural Effusion
(drug therapy, therapy)
- Streptokinase
(therapeutic use)
- Treatment Outcome
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