SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2026
Outcomes of intrapleural fibrinolytic and deoxyribonuclease therapy in pleural infection: a systematic review and meta-analysis.
Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionIntrapleural enzyme therapy (IET) with fibrinolytics and deoxyribonuclease (DNase) is increasingly being added to standard care (SC) for the treatment of pleural infection.
methodsA systematic literature search of the PubMed and Embase databases was conducted from January 2010 to December 2022 to identify studies reporting treatment response, safety or mortality of IET or SC in pleural infection.
results19 studies were included. 12 evaluated treatment response with IET, with a pooled hospital length of stay (LOS) of 12.9 (95% CI 10.4-15.4) days and an average surgery requirement of 11.5% (95% CI 7.2-18.0). In SC, six studies assessed treatment response, with a pooled hospital LOS of 22.7 (95% CI 17.9-27.4) days and a surgery requirement of 23.4% (95% CI 8.3-50.5). The pooled incidence of significant bleeding in the IET group, assessed in 11 studies, was 3.7% (95% CI 2.9-4.5). In-hospital mortality rates were 3.7% (95% CI 1.5-9.1) for IET and 13.7% (95% CI 5.6-29.9) for SC.
conclusionsIET demonstrated a favourable treatment response and lower mortality rate compared to SC, with an acceptable safety profile.
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