TY - JOUR T1 - Pleurodesis for malignant pleural effusions: A comparison of bleomycin or tranexamic acid alone versus a combination of both JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P3072 AU - Essam Mohamed AU - Elsayed Ali AU - Hamdy Mahmoud Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P3072.abstract N2 - BACKGROUND and OBJECTIVE:Searching for the ideal pleurodesis agent still continues, Bleomycin is one of the most commonly used agents for pleurodesis. Tranexamic acid have been reported as a cheap pleurodesis agent by many authors. In this study, we evaluate the efficacy, safety and cost of using a combination of bleomycin and Tranexamic acid versus each agent alone.METHODS:Sixty three patients with massive malignant pleural effusions were divided in 3 equal groups in a simple randomized manner. Tranexamic acid (30 mg/kg [maximum of 2 g] in 50 mL of normal saline) was administered through a chest tube in Group 1. Group 2 received bleomycin (1 U/kg [maximum of 60 U] in 70 mL of normal saline). Group 3 received the above 2 preparations (tranexamic acid, 30 mg/kg [maximum of 2 g] in 40 mL of normal saline and bleomycin, 1 U/kg [maximum of 60 U] in 50 mL of normal saline) instilled one following the other by 15 minutes. Follow-up CXR examinations were performed at 7 days, 30 days, 60 days and 90 days.RESULTS:There was no significant difference in the complete response rate of the 3 groups during the first 60 days days. At the end of the study at 90 days, Group 3 had a significantly higher complete response rate (65 %) compared with Groups 1 and 2 (27 % and 35 %, respectively).The rate of complications was nearly equal in the three groups. The most common complications were chest pain, fever and worsening dyspnea.CONCLUSIONS:Using a combination of bleomycin and tranexamic acid for pleurodesis in patients with malignant pleural effusion is more efficient than using each agent alone without significant increase in the cost or complications. ER -