Published a study on the best treatment for patients with complicated pneumonia that develop a pleural effusion

Researchers at the University Hospital Arnau de Vilanova in Lleida (HUAV), the Biomedical Research Institute of Lleida (IRBLleida) and the Vall d'Hebron University Hospital in Barcelona have published the results of a clinical trial designed to studied the treatment of choice and dosage required in cases of pneumòmia that complicate the accumulation of fluid in the cavity surrounding the lungs. The results has been published in the journal Lung international impact.

The accumulation of fluid in the cavity surrounding the lungs (pleural effusion) observed in 20% of patients with pneumonia. This fluid (pus) is a bacterial infection spread to the pleura. Patients with pneumonia and pleural effusion requiring, in many cases, drainage through a chest tube, the infected fluid. If this is not achieved satisfactorily, patients must undergo surgery. The administration of certain substances (fibrinolytics agents) through the drainage tube facilitates cleaning and complete evacuation of infected fluid, and thus can avoid surgery. However, the two fibrinolytics agents that can be used (or alteplasa urocinasa), it is unknown what is the most beneficial and what is the appropriate dose.

To find the answer to the question, the work has been prepared after studying 99 patients with these characteristics. The conclusion was that the use of fibrinolytics agents administered through a tube directly into the pleura prevents thoracic surgery in 97% of cases. In addition, when you decide to use agents fibrinolytics, urocinasa would be the choice because, although the alteplasa always effective, has fewer adverse effects (such as pleural hemorrhage).

The study was coordinated by Dr. José Manuel Porcel any service HUAV Internal Medicine and head of the research group of diseases of the pleura IRBLleida junatment with Dr. Carmen Alemán service of Internal Medicine Hospital Vall d'Hebron. The study also included co-operation • ade professional pharmacy, radiology and thoracic surgery and support of technical services and pharmacological IRBLleida.

Text: HUAV Press and Communications Office / Press and Communications IRBLleida

Links: Alemán C, Porcel JM, Alegre J, Ruiz E, Bielsa S, Andreu J, Deu M, Suñé P, Martínez-Sogués M, López I, Pallisa E, Schoenenberger JA, Bruno Montoro J, de Sevilla TF. Intrapleural Fibrinolysis with Urokinase Versus Alteplase in Complicated Parapneumonic Pleural Effusions and Empyemas: A Prospecti