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Intrapleural streptokinase in experimental empyema.
Am Rev Respir Dis 1993; 147(4):962-6AR

Abstract

Intrapleural streptokinase has been used in multiloculated empyemas to enhance pleural space drainage, presumably by causing fibrinolysis of the interlocular septae. We evaluated the efficacy and safety of daily administration of 10,000 U intrapleural streptokinase or equal volumes of saline to enhance resolution of experimental empyema in the rabbit pleural space. Seventy-two hours after intrapleural turpentine, 10(8) colony-forming units each of Escherichia coli, Peptostreptococcus anaerobius, and Bacteroides fragilis were injected into the sterile pleural effusion of all animals. Immediately after bacterial inoculation, and daily for 3 days, animals received 10,000 U streptokinase or saline intrapleurally. Animals that achieved a pleural fluid pH < 7.30 and either glucose < 50 mg/dl or LDH > 500 IU/L were included for data analysis. At Day 4 after bacterial inoculation, the streptokinase-treated empyemic rabbits had more pleural fluid (18.8 +/- 5.1 ml) (mean +/- SEM) than did saline-treated control animals (4.8 +/- 1.7 ml) (p = 0.015), fewer interpleural adhesions (8.2 +/- 2.7) than did saline-treated control animals (25.1 +/- 3.6) (p = 0.002), and comparable amounts of visceral and parietal pleural plaque than did saline-treated control animals (p = NS). No evidence of systemic fibrinolysis was observed at 1 h after intrapleural streptokinase administration. We conclude that intrapleural streptokinase decreases interpleural adhesion numbers but fails to reduce the amount of pleural plaque observed in experimental empyema in rabbits. The increases in pleural fluid volume observed after streptokinase administration may be due to mechanisms other than fibrinolytic activity.

Authors+Show Affiliations

Department of Medicine, Medical University of South Carolina, Charleston.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8466134

Citation

Strange, C, et al. "Intrapleural Streptokinase in Experimental Empyema." The American Review of Respiratory Disease, vol. 147, no. 4, 1993, pp. 962-6.
Strange C, Allen ML, Harley R, et al. Intrapleural streptokinase in experimental empyema. Am Rev Respir Dis. 1993;147(4):962-6.
Strange, C., Allen, M. L., Harley, R., Lazarchick, J., & Sahn, S. A. (1993). Intrapleural streptokinase in experimental empyema. The American Review of Respiratory Disease, 147(4), pp. 962-6.
Strange C, et al. Intrapleural Streptokinase in Experimental Empyema. Am Rev Respir Dis. 1993;147(4):962-6. PubMed PMID: 8466134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrapleural streptokinase in experimental empyema. AU - Strange,C, AU - Allen,M L, AU - Harley,R, AU - Lazarchick,J, AU - Sahn,S A, PY - 1993/4/1/pubmed PY - 1993/4/1/medline PY - 1993/4/1/entrez SP - 962 EP - 6 JF - The American review of respiratory disease JO - Am. Rev. Respir. Dis. VL - 147 IS - 4 N2 - Intrapleural streptokinase has been used in multiloculated empyemas to enhance pleural space drainage, presumably by causing fibrinolysis of the interlocular septae. We evaluated the efficacy and safety of daily administration of 10,000 U intrapleural streptokinase or equal volumes of saline to enhance resolution of experimental empyema in the rabbit pleural space. Seventy-two hours after intrapleural turpentine, 10(8) colony-forming units each of Escherichia coli, Peptostreptococcus anaerobius, and Bacteroides fragilis were injected into the sterile pleural effusion of all animals. Immediately after bacterial inoculation, and daily for 3 days, animals received 10,000 U streptokinase or saline intrapleurally. Animals that achieved a pleural fluid pH < 7.30 and either glucose < 50 mg/dl or LDH > 500 IU/L were included for data analysis. At Day 4 after bacterial inoculation, the streptokinase-treated empyemic rabbits had more pleural fluid (18.8 +/- 5.1 ml) (mean +/- SEM) than did saline-treated control animals (4.8 +/- 1.7 ml) (p = 0.015), fewer interpleural adhesions (8.2 +/- 2.7) than did saline-treated control animals (25.1 +/- 3.6) (p = 0.002), and comparable amounts of visceral and parietal pleural plaque than did saline-treated control animals (p = NS). No evidence of systemic fibrinolysis was observed at 1 h after intrapleural streptokinase administration. We conclude that intrapleural streptokinase decreases interpleural adhesion numbers but fails to reduce the amount of pleural plaque observed in experimental empyema in rabbits. The increases in pleural fluid volume observed after streptokinase administration may be due to mechanisms other than fibrinolytic activity. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/8466134/Intrapleural_streptokinase_in_experimental_empyema_ L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm/147.4.962?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -