Comparing Intrapleural Alteplase with Tyloxapol versus Alteplase with DNase for Treating Pleural Infection

What this Trial Is About

Pneumonia, a lung infection, often leads to pleural space infections such as parapneumonic effusions and empyema, which cause significant illness and risk, especially in patients with weakened immune systems. This research compares two intrapleural treatments combining alteplase with either DNase or tyloxapol to evaluate their effectiveness and safety in managing pleural infection. The study aims to address the challenge of draining infected fluid in cases where simple chest tube drainage may not be sufficient due to loculations. The study evaluates two treatment groups one receiving intrapleural alteplase with DNase and the other receiving intrapleural alteplase with tyloxapol. Both treatments involve administering the medications sequentially via a chest tube, with clamping and unclamping periods to promote drainage. Dosages of alteplase range from 5 to 10 mg, with DNase or tyloxapol doses also specified. Treatment timing and chest tube removal are determined by the treating chest physician. This observational study uses data from patients treated from June 2023 to June 2025. Participants are adult patients with pleural infection and poor drainage after chest tube insertion. Researchers will assess changes in pleural opacity on chest x-rays, inflammatory markers like white blood cells and C-reactive protein, and the volume of pleural fluid drained within 72 hours. They will also compare hospital stay lengths, surgical intervention rates, adverse effects, and 30-day mortality. Data collection involves reviewing clinical and imaging records. The study enrolls patients from specific medical centers and concludes in mid-2028.

Intrapleural Alteplase-Tyloxapol vs Intrapleural Alteplase-DNase in Pleural Infection