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Tissue plasminogen activator as an adjuvant therapy for pleural empyema in pediatric patients

Theresa L Ray1, John W Berkenbosch, Pierantonio Russo

  • 1Department of Child Health, The University of Missouri, Columbia, MO 65212, USA.

Journal of Intensive Care Medicine
|March 24, 2004
PubMed

Insights

Tissue plasminogen activator (TPA) significantly improved pleural fluid drainage in pediatric patients with complex empyema. TPA therapy led to reduced fever and shorter hospital stays, demonstrating its efficacy.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Complex empyema in children presents a significant clinical challenge.
  • Current treatment options for pediatric empyema have limitations.

Purpose of the Study:

  • To evaluate the efficacy of tissue plasminogen activator (TPA) in treating complex empyema in pediatric patients.
  • To compare TPA therapy with other empyema treatments regarding cost and risk-benefit.

Main Methods:

  • Retrospective review of 6 pediatric patients (ages 2-13) treated with TPA.
  • Assessment of pleural fluid drainage before and after TPA administration.
  • Monitoring of fever resolution and length of hospital stay.

Main Results:

  • Significant increase in pleural fluid drainage post-TPA (141.7 mL vs. 22.5 mL, P <.0001).
  • Five of six patients became afebrile within 48 hours of TPA initiation.
  • Median hospital stay was 6 days post-TPA therapy.

Conclusions:

  • TPA is an effective treatment for complex pediatric empyema, enhancing drainage and clinical recovery.
  • TPA offers a favorable risk-benefit profile compared to alternative empyema therapies.

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