Evidence map›Paper›PMID 41948066›Full record

Trial reportRespirology case reports2026

A Parallel Group, 1:1 Randomised, Pilot Study Comparing the Clinical Efficacy and Bleeding Risk Between Low Dose and Standard Dose Intrapleural Tissue Plasminogen Activator for Adults With Pleural Infection.

Ken Ka Pang Chan, Christopher Chan, David Shu Cheong Hui, Ai Ling Tan, Y C Gary Lee

Abstract readClinical Trial
In one paragraph

Trial report in Respirology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ken Ka Pang ChanDepartment of Medicine & Therapeutics, Faculty of Medicine Chinese University of Hong Kong Hong Kong China.ORCID https://orcid.org/0000-0002-8163-5846
Christopher ChanDepartment of Medicine & Therapeutics, Faculty of Medicine Chinese University of Hong Kong Hong Kong China.ORCID https://orcid.org/0000-0001-7361-9232
David Shu Cheong HuiDepartment of Medicine & Therapeutics, Faculty of Medicine Chinese University of Hong Kong Hong Kong China.
Ai Ling TanCentre for Innovative Pleural Research, Sir Charles Gairdner Hospital Perth Australia.ORCID https://orcid.org/0009-0004-8956-0537
Y C Gary LeeCentre for Innovative Pleural Research, Sir Charles Gairdner Hospital Perth Australia.ORCID https://orcid.org/0000-0002-0036-511X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A pilot study to assess the feasibility of a randomization trial protocol comparing low (2.5 mg) and standard (10 mg) doses of intrapleural tissue plasminogen activator (tPA) with deoxyribonucleases (DNase) in unresolved pleural infection. The proposed protocol comparing low-dose and standard doses of intrapleural tPA (with DNase) therapy will be feasible and acceptable. Methods: A single-centre, two-arm, double-blinded, randomised controlled feasibility study which includes subjects with unresolved pleural infection eligible for intrapleural tPA/DNase injection, with follow-ups till 3 months after hospital discharge. Recruited subjects will be randomised in a 1:1 ratio to receive a maximum of 6 doses of intrapleural tPA (with DNase) starting at either 2.5 or 10 mg. A clinical decision is allowed at or after the third dose of tPA to continue the assigned regimen (blinded) or convert to open-label use of 10 mg doses of tPA to complete the course based on the clinical response. Discussion: The main outcome is the feasibility of the trial protocol, based on the percentage of eligible patients enrolled, retained to discharge, and completing 3 months of follow-up. Other important outcomes include survival at 3 months follow-up and without the need for surgical intervention, the need for additional pleural interventions, the number of decisions to convert to open-labelled use of 10 mg intrapleural tPA, clinical and radiographic response after the treatment course, safety profiles, especially bleeding complications and the number and reason for protocol violation. Feasibility outcomes will be reported as descriptive data. Comparison of outcomes between the two treatment groups will be analysed on an intention-to-treat basis. Safety outcomes will be reported descriptively for each group. The reported estimates of recruitment rates, adherence, follow-up completeness, and variability and event rates for key clinical and bleeding outcomes will inform the design of future studies that incorporate the current study design.

Indexed as

intrapleural fibrinolytic therapypilot feasibility studypleural infectiontissue plasminogen activator

Identifiers

PMID41948066
PMCPMC13052186

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.