ArticlePloS one2021
Intrapleural use of urokinase and DNase in pleural infections managed with repeated thoracentesis: A comparative cohort study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- A feasibility randomised trial comparing therapeutic thoracentesis to chest tube insertion for the management of pleural infection: results from the ACTion trial.BMC pulmonary medicine · 2022Trial
- A Practical Approach to Pleural Infection.Pulmonary therapy · 2025Article
- Chest tube drainage versus repeated therapeutic thoracentesis for the management of pleural infections: a retrospective multicentre propensity-matched study.Pneumonia (Nathan Qld.) · 2025Article
- Chest drainage or repeated thoracentesis for pleural infections: a clinical dilemma.Pneumonia (Nathan Qld.) · 2025Article
- Efficacy of medical thoracoscopy combined with fibrinolytic therapy in the treatment of complicated parapneumonic effusions and empyema.BMC pulmonary medicine · 2025Article
- Diagnosis and management of pleural infection.Breathe (Sheffield, England) · 2023Review
- Does the time to diagnosis and treatment influence outcome in adults with pleural infections.European clinical respiratory journal · 2023Review
- Intrapleural Instillation of Sodium Bicarbonate versus Urokinase in Management of Complicated Pleural Effusion: A Comparative Cohort Study.International journal of general medicine · 2022Article
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionEvacuation of infected fluid in pleural infections is essential. To date, the use of an intrapleural fibrinolytic agent such as urokinase and DNase has not yet been assessed in infections managed by repeated therapeutic thoracentesis (RTT).
methodsWe performed a retrospective comparative study of two successive cohorts of consecutive patients with pleural infections from 2001 to 2018. Between 2001 and 2010, patients had RTT with intrapleural urokinase (RTT-U). After 2011, patients received intrapleural urokinase and DNase with RTT (RTT-UD). Data were collected through a standardized questionnaire.
resultsOne hundred and thirty-three patients were included: 93 were men and the mean age was 59 years (standard deviation 17.2). Eighty-one patients were treated with a combination of intrapleural urokinase and DNase, and 52 were treated with intrapleural urokinase only. In the RTT-UD, RTT failure occurred in 14 patients (17%) compared to 10 (19%) in the RTT-U group (P = 0.82). There was no difference between the two groups in intensive care unit admission, surgical referrals or in-hospital mortality. RTT-UD was associated with faster time to apyrexia (aOR = 0.51, 95%CI [0.37-0.72]), a reduced length of hospital stay (aOR = 0.61, 95%CI [0.52-0.73]) and a higher volume of total pleural fluid retrieved (aOR = 1.38, 95%CI [1.02-1.88]). Complications were rare with only one hemothorax in the RTT-UD group and no pneumothorax requiring drainage in either group.
conclusionCompared to urokinase only, intrapleural use of urokinase and DNase in RTT was associated with quicker defervescence, shorter hospital stay and increased volumes of pleural fluid drained. Randomized controlled trials evaluating urokinase and DNase with RTT technique would be required to confirm these results.
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