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. 1998 Aug;53(Suppl 2):S65–S72. doi: 10.1136/thx.53.2008.s65

Use of fibrinolytic agents in the management of complicated parapneumonic effusions and empyemas

S A Sahn
PMCID: PMC1765903  PMID: 10193351

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Selected References

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  1. Alfageme I., Vázquez R. Ventricular fibrillation after intrapleural urokinase. Intensive Care Med. 1997 Mar;23(3):352–352. [PubMed] [Google Scholar]
  2. Ashbaugh D. G. Empyema thoracis. Factors influencing morbidity and mortality. Chest. 1991 May;99(5):1162–1165. doi: 10.1378/chest.99.5.1162. [DOI] [PubMed] [Google Scholar]
  3. Bartlett J. G., Finegold S. M. Anaerobic infections of the lung and pleural space. Am Rev Respir Dis. 1974 Jul;110(1):56–77. doi: 10.1164/arrd.1974.110.1.56. [DOI] [PubMed] [Google Scholar]
  4. Bouros D., Schiza S., Panagou P., Drositis J., Siafakas N. Role of streptokinase in the treatment of acute loculated parapneumonic pleural effusions and empyema. Thorax. 1994 Sep;49(9):852–855. doi: 10.1136/thx.49.9.852. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Braman S. S., Donat W. E. Explosive pleuritis. Manifestation of group A beta-hemolytic streptococcal infection. Am J Med. 1986 Oct;81(4):723–726. doi: 10.1016/0002-9343(86)90567-x. [DOI] [PubMed] [Google Scholar]
  6. CARE A. D. Goitrogenic properties of linseed. Nature. 1954 Jan 23;173(4395):172–173. doi: 10.1038/173172b0. [DOI] [PubMed] [Google Scholar]
  7. Chin N. K., Lim T. K. Controlled trial of intrapleural streptokinase in the treatment of pleural empyema and complicated parapneumonic effusions. Chest. 1997 Feb;111(2):275–279. doi: 10.1378/chest.111.2.275. [DOI] [PubMed] [Google Scholar]
  8. Davies C. W., Lok S., Davies R. J. The systemic fibrinolytic activity of intrapleural streptokinase. Am J Respir Crit Care Med. 1998 Jan;157(1):328–330. doi: 10.1164/ajrccm.157.1.97-03094. [DOI] [PubMed] [Google Scholar]
  9. Ferguson A. D., Prescott R. J., Selkon J. B., Watson D., Swinburn C. R. The clinical course and management of thoracic empyema. QJM. 1996 Apr;89(4):285–289. doi: 10.1093/qjmed/89.4.285. [DOI] [PubMed] [Google Scholar]
  10. Frye M. D., Jarratt M., Sahn S. A. Acute hypoxemic respiratory failure following intrapleural thrombolytic therapy for hemothorax. Chest. 1994 May;105(5):1595–1596. doi: 10.1378/chest.105.5.1595. [DOI] [PubMed] [Google Scholar]
  11. Godley P. J., Bell R. C. Major hemorrhage following administration of intrapleural streptokinase. Chest. 1984 Sep;86(3):486–487. doi: 10.1378/chest.86.3.486. [DOI] [PubMed] [Google Scholar]
  12. Heffner J. E., Brown L. K., Barbieri C., DeLeo J. M. Pleural fluid chemical analysis in parapneumonic effusions. A meta-analysis. Am J Respir Crit Care Med. 1995 Jun;151(6):1700–1708. doi: 10.1164/ajrccm.151.6.7767510. [DOI] [PubMed] [Google Scholar]
  13. Heffner J. E., McDonald J., Barbieri C., Klein J. Management of parapneumonic effusions. An analysis of physician practice patterns. Arch Surg. 1995 Apr;130(4):433–438. doi: 10.1001/archsurg.1995.01430040095021. [DOI] [PubMed] [Google Scholar]
  14. Himelman R. B., Callen P. W. The prognostic value of loculations in parapneumonic pleural effusions. Chest. 1986 Dec;90(6):852–856. doi: 10.1378/chest.90.6.852. [DOI] [PubMed] [Google Scholar]
  15. Jerjes-Sánchez C., Ramirez-Rivera A., Elizalde J. J., Delgado R., Cicero R., Ibarra-Perez C., Arroliga A. C., Padua A., Portales A., Villarreal A. Intrapleural fibrinolysis with streptokinase as an adjunctive treatment in hemothorax and empyema: a multicenter trial. Chest. 1996 Jun;109(6):1514–1519. doi: 10.1378/chest.109.6.1514. [DOI] [PubMed] [Google Scholar]
  16. Lee K. S., Im J. G., Kim Y. H., Hwang S. H., Bae W. K., Lee B. H. Treatment of thoracic multiloculated empyemas with intracavitary urokinase: a prospective study. Radiology. 1991 Jun;179(3):771–775. doi: 10.1148/radiology.179.3.2027990. [DOI] [PubMed] [Google Scholar]
  17. Light R. W., Girard W. M., Jenkinson S. G., George R. B. Parapneumonic effusions. Am J Med. 1980 Oct;69(4):507–512. doi: 10.1016/0002-9343(80)90460-x. [DOI] [PubMed] [Google Scholar]
  18. Light R. W., MacGregor M. I., Ball W. C., Jr, Luchsinger P. C. Diagnostic significance of pleural fluid pH and PCO2. Chest. 1973 Nov;64(5):591–596. doi: 10.1378/chest.64.5.591. [DOI] [PubMed] [Google Scholar]
  19. McLoud T. C., Flower C. D. Imaging the pleura: sonography, CT, and MR imaging. AJR Am J Roentgenol. 1991 Jun;156(6):1145–1153. doi: 10.2214/ajr.156.6.2028857. [DOI] [PubMed] [Google Scholar]
  20. Mitchell M. E., Alberts W. M., Chandler K. W., Goldman A. L. Intrapleural streptokinase in management of parapneumonic effusions. Report of series and review of literature. J Fla Med Assoc. 1989 Dec;76(12):1019–1022. [PubMed] [Google Scholar]
  21. Park C. S., Chung W. M., Lim M. K., Cho C. H., Suh C. H., Chung W. K. Transcatheter instillation of urokinase into loculated pleural effusion: analysis of treatment effect. AJR Am J Roentgenol. 1996 Sep;167(3):649–652. doi: 10.2214/ajr.167.3.8751672. [DOI] [PubMed] [Google Scholar]
  22. Pfeifer G. W., Doerr F., Brod K. H. Zur Pharmakokinetik von 131J-Streptokinase am Menschen. Klin Wochenschr. 1969 May 1;47(9):482–486. doi: 10.1007/BF01745853. [DOI] [PubMed] [Google Scholar]
  23. Poe R. H., Marin M. G., Israel R. H., Kallay M. C. Utility of pleural fluid analysis in predicting tube thoracostomy/decortication in parapneumonic effusions. Chest. 1991 Oct;100(4):963–967. doi: 10.1378/chest.100.4.963. [DOI] [PubMed] [Google Scholar]
  24. Pollak J. S., Passik C. S. Intrapleural urokinase in the treatment of loculated pleural effusions. Chest. 1994 Mar;105(3):868–873. doi: 10.1378/chest.105.3.868. [DOI] [PubMed] [Google Scholar]
  25. Potts D. E., Taryle D. A., Sahn S. A. The glucose-pH relationship in parapneumonic effusions. Arch Intern Med. 1978 Sep;138(9):1378–1380. [PubMed] [Google Scholar]
  26. Roupie E., Bouabdallah K., Delclaux C., Brun-Buisson C., Lemaire F., Vasile N., Brochard L. Intrapleural administration of streptokinase in complicated purulent pleural effusion: a CT-guided strategy. Intensive Care Med. 1996 Dec;22(12):1351–1353. doi: 10.1007/BF01709550. [DOI] [PubMed] [Google Scholar]
  27. Sahn S. A. Management of complicated parapneumonic effusions. Am Rev Respir Dis. 1993 Sep;148(3):813–817. doi: 10.1164/ajrccm/148.3.813. [DOI] [PubMed] [Google Scholar]
  28. Stark D. D., Federle M. P., Goodman P. C., Podrasky A. E., Webb W. R. Differentiating lung abscess and empyema: radiography and computed tomography. AJR Am J Roentgenol. 1983 Jul;141(1):163–167. doi: 10.2214/ajr.141.1.163. [DOI] [PubMed] [Google Scholar]
  29. Strange C., Sahn S. A. The clinician's perspective on parapneumonic effusions and empyema. Chest. 1993 Jan;103(1):259–261. doi: 10.1378/chest.103.1.259. [DOI] [PubMed] [Google Scholar]
  30. Taryle D. A., Potts D. E., Sahn S. A. The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. Chest. 1978 Aug;74(2):170–173. doi: 10.1378/chest.74.2.170. [DOI] [PubMed] [Google Scholar]
  31. Taylor R. F., Rubens M. B., Pearson M. C., Barnes N. C. Intrapleural streptokinase in the management of empyema. Thorax. 1994 Sep;49(9):856–859. doi: 10.1136/thx.49.9.856. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Temes R. T., Follis F., Kessler R. M., Pett S. B., Jr, Wernly J. A. Intrapleural fibrinolytics in management of empyema thoracis. Chest. 1996 Jul;110(1):102–106. doi: 10.1378/chest.110.1.102. [DOI] [PubMed] [Google Scholar]
  33. Tillett W. S., Sherry S. THE EFFECT IN PATIENTS OF STREPTOCOCCAL FIBRINOLYSIN (STREPTOKINASE) AND STREPTOCOCCAL DESOXYRIBONUCLEASE ON FIBRINOUS, PURULENT, AND SANGUINOUS PLEURAL EXUDATIONS. J Clin Invest. 1949 Jan;28(1):173–190. doi: 10.1172/JCI102046. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Vidovich R. R., Heiselman D. E., Hudock D. Treatment of urokinase-related anaphylactoid reaction with intravenous famotidine. Ann Pharmacother. 1992 Jun;26(6):782–783. doi: 10.1177/106002809202600608. [DOI] [PubMed] [Google Scholar]
  35. Wait M. A., Sharma S., Hohn J., Dal Nogare A. A randomized trial of empyema therapy. Chest. 1997 Jun;111(6):1548–1551. doi: 10.1378/chest.111.6.1548. [DOI] [PubMed] [Google Scholar]
  36. Wang N. S. The preformed stomas connecting the pleural cavity and the lymphatics in the parietal pleura. Am Rev Respir Dis. 1975 Jan;111(1):12–20. doi: 10.1164/arrd.1975.111.1.12. [DOI] [PubMed] [Google Scholar]
  37. Willsie-Ediger S. K., Salzman G., Reisz G., Foreman M. G. Use of intrapleural streptokinase in the treatment of thoracic empyema. Am J Med Sci. 1990 Nov;300(5):296–300. doi: 10.1097/00000441-199011000-00005. [DOI] [PubMed] [Google Scholar]
  38. Yang P. C., Luh K. T., Chang D. B., Wu H. D., Yu C. J., Kuo S. H. Value of sonography in determining the nature of pleural effusion: analysis of 320 cases. AJR Am J Roentgenol. 1992 Jul;159(1):29–33. doi: 10.2214/ajr.159.1.1609716. [DOI] [PubMed] [Google Scholar]

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