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Evaluation of chest tube administration of tissue plasminogen activator to treat retained hemothorax.
MedLine Citation:
PMID:  24495319     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
P J Stiles; Rachel M Drake; Stephen D Helmer; Paul M Bjordahl; James M Haan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-4
Journal Detail:
Title:  American journal of surgery     Volume:  -     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-2-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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