XXXX after administration of tPA: a case report and review of the literature.

@entity1 @entity1143 @entity548 @entity1003 @entity177
OBJECTIVE: Intrapleural fibrinolytic enzymes have been used for over 60 years in the treatment of complicated pleural effusions to lyse loculations and promote resolution. Despite this extensive history of use, however, little is known about complications that may arise with the use of this therapy. Here we discuss a @entity1 with @entity177 on hemodialysis who developed an @entity548 after the administration of intrapleural tPA to treat a complicated parapneumonic effusion. A review of the literature examines the efficacy and safety of this therapy, focusing on @entity548 complications. Specific attention is paid to @entity1 who have underlying @entity1003 or who are receiving anticoagulation. DATA SOURCES: A review of the literature, as indexed in PubMed, was undertaken using the following search terms in combination: tPA, @entity1143 , complications of thrombolytics, and @entity548 . The search was inclusive of @entity1 under the age of 18, but was limited by English language and @entity1 subjects. STUDY SELECTION/DATA EXTRACTION: All relevant articles identified during the search were reviewed. Those studies that reported on @entity548 complications, or lack thereof, were included in this review. Limitations of each article are noted in the text. CONCLUSIONS: Multiple studies, including a 2000 ACP consensus statement and a 2008 Cochrane review, indicate the need for further investigations to evaluate the safety and efficacy of intrapleural thrombolytics for the treatment of complicated @entity1143 . Limited studies specifically address @entity548 complications, especially in subpopulations of @entity1 receiving concurrent anticoagulant therapy.
