PT - JOURNAL ARTICLE AU - Mabrouk Bashir AU - Khalifa Mousbah AU - Abdelwahed Gdeedo TI - Effectiveness and safety of tissue plasminogen activators (t-PA) in complicated pleural effusion (CPE), what the correlation with time it stays in the pleural space? DP - 2013 Sep 01 TA - European Respiratory Journal PG - 5040 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/5040.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/5040.full SO - Eur Respir J2013 Sep 01; 42 AB - Objectives: Previous observations on the use of fibrinolytics in (CPE) were made after its use as repeated daily doses, but this study aimed to evaluate for the first time, the effectiveness and safety of single (t-PA) dose kept longer in the pleural space, versus repeated daily doses or using normal saline in (CPE) patients.Methods: prospective study included 66 adults diagnosed with (CPE) on basis of C.T findings.The patients randomly divided into three groups, as to receive single (t-PA) dose kept for 24hrs, or to receive three successive daily installations kept 2hrs each time, the 3rd group receive normal saline kept in the pleural space over 24hrs.The drained fluid measured daily, and the drain removed once the collection is less than 30ml, chest x-ray done at discharge, and chest C.T at one month later.Results: All patients finished the therapeutic intervention without any important complications, apart from self- limited hematuria in 2 patients.In achieving complete fluid drainage, fewer days taken with single (t-PA) dose than with repeated installations.The first day drainage was significantly high with single dose installation, as well 43 patients out of 44 who received (t-PA) had complete fluid drainage and disappearance of pleural adhesions, but patients received normal saline, all were referred for further surgical intervention.Conclusion: The (t-PA) is safe and more effective than normal saline in patients with (CPE) and its effectiveness looks to be correlated with the time it stays in the pleural space rather than from repetition of agent doses.