Intrapleural Fibrinolytic Therapy for Residual Coagulated Hemothorax After Lung Surgery

Huang, Dayu; Zhao, Deping; Zhou, Yiming; Liu, Hongchen; Chen, Xiaofeng

doi:10.1007/s00268-015-3378-9

Cited by 10 publications

(9 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years, the use of a tissue plasminogen activator (tPA) such as urokinase, which liquefies the clotted hemothorax, has come up as a less invasive method for treatment (8). Fibrinolytic agents as streptokinase or urokinase have been used safely in the posttraumatic hemothorax setting (9) or after lung resections (10). The risk of relevant bleeding using these agents is described in the literature with 2-15% in mostly immunocompetent patients.…”

Section: Discussionmentioning

confidence: 99%

Urokinase application for hemothorax in pulmonary mucormycosis

İnci

Schanz

et al. 2018

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Urokinase application for hemothorax in pulmonary mucormycosis

İnci

Schanz

et al. 2018

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…In addition, it can dissolve the cellulose deposited on the pulmonary surface, which makes pulmonary reexpansion possible. Because this method is simple and provides a way of treating patients without great economic burden or special equipment, it deserves broader application [1]. In the present study, 61 patients were eligible for thoracic puncture and chest tube drainage.…”

Section: The Treatment Of Thoracic Trauma Combined With Atelectasismentioning

confidence: 99%

Analysis of the therapeutic effect and prognosis in 86 cases of rib fractures and atelectasis

Yin

Wang

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

Background The aim of the present study was to explore the therapeutic effect and prognosis in patients with rib fractures and atelectasis after thoracic trauma in order to provide a basis for clinical decision-making in primary hospitals. Methods A retrospective study was conducted on 86 patients admitted to our hospital between January 2016 and May 2020 with rib fractures and atelectasis after thoracic trauma. On the basis of the chest computed tomography scans taken at the time of discharge, the patients were divided into two groups: the reexpansion group and the non-reexpansion group. The two groups were compared with respect to the changes observed in the patients’ levels of blood oxygen saturation (SpO2) and pulmonary function, the presence of secondary pulmonary or thoracic infection, the time of chest tube drainage, the length of hospitalization, the cost of hospitalization, and the patients’ level of satisfaction with their quality of life 3 months after discharge. Results In the reexpansion group, there were significant differences in the levels of SpO2 and pulmonary function measured before and after pulmonary reexpansion (P < 0.05). Compared with the non-reexpansion group, the patients in the reexpansion group had a lower incidence of secondary pulmonary and thoracic infection and a higher level of satisfaction with their quality of life after discharge; these differences were statistically significant (P < 0.05). There was no statistical significance between the two groups with respect to the time of chest tube drainage or the length of hospitalization (P > 0.05). However, the cost of hospitalization was significantly higher in the reexpansion group than in the non-reexpansion group (P < 0.05). Conclusions The patients in the pulmonary reexpansion group had a lower incidence of complications and a better prognosis than the patients in the non-reexpansion group.

show abstract

“…1,9,14,21 Fibrinolytic agents, such as streptokinase and urokinase, convert plasminogen to plasmin, which breaks down fibrin within clot and adhesions. Theoretically, the dissolution of clot and loculations should improve evacuation of retained collections, [23][24][25] but in the 2012 AAST trial, of the 15 patients initially treated with IPFT, 10 (67%) required a second procedure. 9 Conversely, Kimbrell and colleagues successfully treated 23/25 (92%) RH that were at least 300 mL on CT with IPFT 21 and other small studies have shown similar success in management of RH with IPFT.…”

Section: Intra-pleural Fibrinolytic Therapymentioning

confidence: 99%

“…27,28 Although not dealing specifically with traumatic RH, IPFT effectively treated 91.3% of 46 patients with sizable RH (>1/3 of the hemithorax) after elective lung surgery, with an average of 6.2 days between the original surgery and IPFT initiation. 23 While the literature has yet to adequately characterize the ideal IPFT group, perhaps those with low volume RH or who could not tolerate an operation would be good candidates for IPFT. Such a group could also still result in cost savings, despite the cost of the fibrinolytics.…”

Section: Intra-pleural Fibrinolytic Therapymentioning

confidence: 99%

Management of post-traumatic retained hemothorax

Bozzay

Bradley

2018

Trauma

View full text Add to dashboard Cite

Introduction: Chest injuries occur in a significant portion of trauma patients and hemothorax is a common result. While the initial management of traumatic hemothorax is most commonly treated with tube thoracostomy, the management of retained hemothorax is a subject of debate. Recent literature has proposed different methods for treating or preventing retained hemothorax, yet the approach to this pathology is not straightforward. Methods: The literature was reviewed for relevant studies regarding the prevention and management of post-traumatic retained hemothorax. What follows is a review of the recent literature and an algorithm for the approach to treating a traumatic retained hemothorax. Results: Identifying a traumatic retained hemothorax and preventing subsequent complications such as pneumonia, empyema, and fibrothorax are significant issues faced by surgeons. Studies for preventing retained hemothorax have focused on initial chest tube size, location, and peri-procedural placement conditions, as well as thoracic lavage. Several treatment modalities exist, including second drainage procedure and intra-pleural fibrinolytic drug instillation, but videoassisted thoracoscopic surgery is the most common and successful approach. Regardless of the approach to evacuation, early intervention is paramount. Conclusion: Further studies will help characterize appropriate candidates, timing, treatment modalities, and guide therapy for retained hemothorax.

show abstract

Intrapleural Fibrinolytic Therapy for Residual Coagulated Hemothorax After Lung Surgery

Abstract: Intrapleural fibrinolytic agents should be considered a useful therapeutic option for the treatment of postoperative residual hemothorax. This method appears to be safe and effective in >90 % of patients with postoperative hemothorax.

Cited by 10 publications

References 51 publications

Urokinase application for hemothorax in pulmonary mucormycosis

Urokinase application for hemothorax in pulmonary mucormycosis

Analysis of the therapeutic effect and prognosis in 86 cases of rib fractures and atelectasis

Management of post-traumatic retained hemothorax

Contact Info

Product

Resources

About