Rationale: Intrapleural tPA/DNase therapy for @entity281 given at the time of diagnosis has been shown to significantly improve radiological outcomes. Published cases are limited to a single randomized control trial and few case reports only. Objective: Multinational observation series to evaluate the pragmatic "real-life" application of tPA/DNase treatment for @entity281 in a large cohort of unselected @entity1 . Methods: All @entity1 from eight centers who received intrapleural tPA/DNase for @entity281 between January 2010 and September 2013 were included. Measured outcomes included treatment success at 30 days, volume of pleural fluid drained, improvement in radiographic @entity231 and inflammatory markers, need for surgery and adverse events. Measurement and Main Results: Of 107 @entity1 treated, the majority (92.3%) were successfully managed without necessitating surgical intervention. No @entity1 died from @entity281 . Most (84%) @entity1 received tPA/DNase more than 24 hours after failing to respond to initial conservative management with antibiotics and thoracostomy. tPA/DNase increased fluid drained from 250mL(median, IQR 100-654) in the preceding 24h to 2475mL(1800-3585) in the 72h following commencement of intrapleural therapy (p<0.05). A corresponding clearance of @entity231 on chest radiographs from 35% (median, IQR 25-31) to 14% (7-28) of the hemithorax (p<0.001), and significant reduction in @entity1851 (p<0.05) were observed. @entity158 necessitating escalation of @entity1337 occurred in 19.6% and @entity548 in 1.8% of @entity1 . Conclusion: This largest series of intrapleural tPA/DNase therapy provides important evidence that the treatment is effective and safe especially as a 'rescue therapy' in @entity1 who failed to initially respond to antibiotics and thoracostomy drainage.

Intrapleural tPA and DNase for XXXX : an effective and safe alternative to surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity231 :: ('MESH:D002386', 'Disease') :: ['pleural opacity'] @entity548 :: ('MESH:D006470', 'Disease') :: ['non-fatal bleeding'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity281 :: ('MESH:D007239', 'Disease') :: ['pleural infection'] @entity158 :: ('MESH:D010146', 'Disease') :: ['Pain'] @entity1851 :: ('1401', 'Gene') :: ['C-reactive protein']
@entity281 :: (MESH:D007239,Disease) :: ['Pleural Infection']
