Intrapleural fibrinolytic therapy by urokinase for acute empyema

Abstract

Intrapleural fibrinolytic therapy for acute empyema has been indicated as effective for patients not cured by thoracic drainage. However, its degree of efficacy has not yet been fully investigated. We retrospectively studied 7 patients (6 males, 1 female) who were treated with intrapleural fibrinolytic therapy by urokinase for acute empyema at our hospital. The mean age was 65.0 years old. There were 5 patients with pre-existing conditions, such as schizophrenia, alcoholism, or hypertension. The performance status (PS) was 1 in 3 patients, and more than 2 in 4 patients. The mean number of urokinase instillations was 2.9 times in 7 patients, and 6 patients were cured by intrapleural fibrinolytic therapy. The mean drainage time in the 6 patients who were cured by intrapleural fibrinolytic therapy was 6.7 days. All 7 patients recovered without major complications such as bleeding or anaphylactic shock. We suggest that intrapleural fibrinolytic therapy by urokinase should be considered as a suitable treatment when surgical treatment for acute empyema is not appropriate.