Intrapleural urokinase in the management of parapneumonic empyema: a randomised controlled trial.

Abstract

We compared the effectiveness of intrapleural urokinase versus normal saline via a thoracostomy tube in the treatment of parapneumonic empyema in a randomised controlled study. Forty-nine patients with parapneumonic empyema were randomly assigned to receive either intrapleural urokinase or normal saline treatment. The daily volume instilled through a chest tube was 100 ml in both groups. Urokinase (100,000 IU/day) was diluted in normal saline before instillation. The mean duration for defervescence was shorter (7 +/- 3 vs 13 +/- 5 days, p<0.01) and the mean volume of drained fluid during the five-day treatment period was significantly greater in the urokinase group (1.8 +/- 1.5 vs 0.8 +/- 0.8 litres, p<0.001) than in the control group. The subsequent decortication rate was 60% and 29.1%, respectively (p<0.001). The duration of hospitalisation was also shorter in the urokinase group (14 +/- 4 vs 21 +/- 4 days, p<0.001) than in the saline group. We conclude that intrapleural instillation of urokinase in the management of parapneumonic empyema provides a better outcome and reduces the need for decortication.

• Authors: B Tuncozgur, H Ustunsoy, M C Sivrikoz, O Dikensoy, M Topal, M Sanli, L Elbeyli
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 55 Issue 10 Pg. 658-60 (Dec 2001) ISSN: 1368-5031 [Print] India
• PMID: 11777287 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Plasminogen Activators
• Urokinase-Type Plasminogen Activator

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Empyema, Pleural (drug therapy, microbiology)
• Female
• Humans
• Male
• Middle Aged
• Plasminogen Activators (therapeutic use)
• Pleural Effusion (microbiology)
• Prospective Studies
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (therapeutic use)