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    Bleeding risk with combination intrapleural fibrinolytic and enzyme therapy in pleural infection - an international, multicenter, retrospective cohort study.

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    Author
    Akulian, Jason
    Bedawi, Eihab O
    Abbas, Hawazin
    Argento, Christine
    Arnold, David T
    Balwan, Akshu
    Batra, Hitesh
    Uribe Becerra, Juan Pablo
    Belanger, Adam
    Berger, Kristen
    Burks, Allen Cole
    Chang, Jiwoon
    Chrissian, Ara A
    DiBardino, David M
    Fuentes, Xavier Fonseca
    Gesthalter, Yaron B
    Gilbert, Christopher R
    Glisinski, Kristen
    Godfrey, Mark
    Gorden, Jed A
    Grosu, Horiana
    Gupta, Mridul
    Kheir, Fayez
    Ma, Kevin C
    Majid, Adnan
    Maldonado, Fabien
    Maskell, Nick A
    Mehta, Hiren
    Mercer, Joshua
    Mullon, John
    Nelson, Darlene
    Nguyen, Elaine
    Pickering, Edward M
    Puchalski, Jonathan
    Reddy, Chakravarthy
    Revelo, Alberto E
    Roller, Lance
    Sachdeva, Ashutosh
    Sanchez, Trinidad
    Sathyanarayan, Priya
    Semaan, Roy
    Senitko, Michal
    Shojaee, Samira
    Story, Ryan
    Thiboutot, Jeffrey
    Wahidi, Momen
    Wilshire, Candice L
    Yu, Diana
    Zouk, Aline
    Rahman, Najib M
    Yarmus, Lonny
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    Date
    2022-06-15
    Journal
    Chest
    Publisher
    Elsevier
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1016/j.chest.2022.06.008
    Abstract
    Overall pleural bleeding incidence was 76/1833=4.1% (95%CI 3.0% to 5.0%). Using a half-dose regimen (tPA 5mg) did not significantly change this risk (6/172=3.5%; p=0.68). Therapeutic anticoagulation (AC) alongside IET was associated with increased bleeding rates (19/197=9.6%) compared to temporarily withholding AC prior to administration of IET (3/118=2.6%, p=0.017). As well as systemic AC, increasing RAPID score, an elevated serum urea and platelets <100x109 L were associated with a significant increase in bleeding risk. However, only RAPID score and use of systemic AC were independently predictive. Apart from pain, non-bleed complications were rare.
    Rights/Terms
    Copyright © 2022. Published by Elsevier Inc.
    Keyword
    bleeding
    empyema
    fibrinolysis
    intrapleural
    parapneumonic pleural effusion
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/19252
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.chest.2022.06.008
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