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Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration

Successful treatment of traumatic hemothoraces is imperative to reduce morbidity and mortality among patients. Treatment modalities range from more conservative to invasive measures, including antibiotic therapy, thoracostomy tube placement, video-assisted thoracoscopic surgery, or thoracotomy. Vari...

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Autores principales: Pastoressa, Melissa, Ma, Truong, Panno, Nicholas, Firstenberg, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479075/
https://www.ncbi.nlm.nih.gov/pubmed/28660167
http://dx.doi.org/10.4103/2229-5151.207741
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author Pastoressa, Melissa
Ma, Truong
Panno, Nicholas
Firstenberg, Michael
author_facet Pastoressa, Melissa
Ma, Truong
Panno, Nicholas
Firstenberg, Michael
author_sort Pastoressa, Melissa
collection PubMed
description Successful treatment of traumatic hemothoraces is imperative to reduce morbidity and mortality among patients. Treatment modalities range from more conservative to invasive measures, including antibiotic therapy, thoracostomy tube placement, video-assisted thoracoscopic surgery, or thoracotomy. Various studies have documented success in using fibrinolytics such as tissue plasminogen activator (tPA) in conjunction with deoxyribonuclease administered through a chest tube to resolve a hemothorax. The optimal dose and frequency of fibrinolytic therapy have not yet been determined although most studies report administering therapy two times a day for 3 days. We report a successful case of a one-time dose of fibrinolytic therapy through thoracostomy tube which could support that a single dose may be ideal and sufficient enough to resolve a hemothorax. We also performed this in the acute postoperative period, which has not been well studied, and believe fibrinolytic therapy can be safe to use in this setting.
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spelling pubmed-54790752017-06-28 Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration Pastoressa, Melissa Ma, Truong Panno, Nicholas Firstenberg, Michael Int J Crit Illn Inj Sci Case Report Successful treatment of traumatic hemothoraces is imperative to reduce morbidity and mortality among patients. Treatment modalities range from more conservative to invasive measures, including antibiotic therapy, thoracostomy tube placement, video-assisted thoracoscopic surgery, or thoracotomy. Various studies have documented success in using fibrinolytics such as tissue plasminogen activator (tPA) in conjunction with deoxyribonuclease administered through a chest tube to resolve a hemothorax. The optimal dose and frequency of fibrinolytic therapy have not yet been determined although most studies report administering therapy two times a day for 3 days. We report a successful case of a one-time dose of fibrinolytic therapy through thoracostomy tube which could support that a single dose may be ideal and sufficient enough to resolve a hemothorax. We also performed this in the acute postoperative period, which has not been well studied, and believe fibrinolytic therapy can be safe to use in this setting. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5479075/ /pubmed/28660167 http://dx.doi.org/10.4103/2229-5151.207741 Text en Copyright: © 2017 International Journal of Critical Illness and Injury Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Pastoressa, Melissa
Ma, Truong
Panno, Nicholas
Firstenberg, Michael
Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title_full Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title_fullStr Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title_full_unstemmed Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title_short Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration
title_sort tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: a safe alternative to postoperative re-exploration
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479075/
https://www.ncbi.nlm.nih.gov/pubmed/28660167
http://dx.doi.org/10.4103/2229-5151.207741
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