Intrapleural alteplase therapy: what are the knowns and unknowns?

Cas Lek Cesk. 2019 Winter;158(7-8):295-299.

Abstract

In pneumology, enzymatic properties of plasmin are used to disrupt fibrin adhesions and septations formed during pathological conditions of the pleural cavity. In that case, fibrinolytics are administrated locally via a chest tube in the pleural cavity to evacuate pathological effusion. Although the first intrapleural administration of fibrinolytic occurred seventy years ago, there has been no consensus on dosing or a uniform procedure of their application. The aim of the article is to summarize current knowledge of alteplase usage in pneumology and discuss practical aspects of its intrapleural application regarding specific possibilities in the Czech Republic.

Keywords: alteplase; fibrinolytic therapy; intrapleural fibrinolytics; pleural infection.

MeSH terms

  • Czech Republic
  • Empyema, Pleural* / drug therapy
  • Fibrinolytic Agents* / administration & dosage
  • Humans
  • Pleural Effusion* / drug therapy
  • Tissue Plasminogen Activator* / administration & dosage

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator