Abstract
Background
When retained hemothorax occurs, video-assisted thoracoscopy or thoracotomy is performed,
but recently, tissue plasminogen activator (tPA) has been used. This study evaluated
intrapleural tPA use for retained traumatic hemothoraces.
Methods
A retrospective review was conducted of trauma patients treated with intrapleural
tPA for retained hemothorax. Data included demographics, past medical and surgical
histories, injury details, treatment details, and outcomes.
Results
Seven patients (median age = 47 years, male = 6, blunt trauma = 6) met study criteria.
All patients received a chest tube. Six patients later received computed tomography-guided
drains for tPA infusion. Number of tPA treatments per patient varied from 1 to 5.
Median total tPA dosage was 24 mg. Median time from injury to chest tube placement
was 11 days and from chest tube placement to first tPA treatment was 4 days. No patients
required a video-assisted thoracoscopy; however, 1 patient required thoracotomy. There
were no deaths or bleeding complications attributed to intrapleural tPA.
Conclusion
Although future studies are needed to identify optimum treatment guidelines, intrapleural
tPA appears to be a safe and efficacious treatment option.
Keywords
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Article info
Publication history
Published online: January 06, 2014
Received in revised form:
August 2,
2013
Received:
July 19,
2013
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
