Retained Hemothorax
Conditions
Keywords
non-surgical rate
Brief summary
Intrapleural thrombolytic treatment with urokinase for retained hemothorax is effective and safe. However, previous study was limited in prospective observation study without control group.
Detailed description
We will recruit 32 patients in this study. The patients with retained hemothorax will be randomly divided into the urokinase group and the placebo group. In the urokinase group, urokinase 100,000 IU in 100 mL NaCl will be injected into the intrapleural space. We will record the daily drainage amount and evaluate the therapeutic effect by the chest X-ray. The therapeutic effect, safety, hospital stay, and medical cost between the two groups will be compared. This study will be done in four medical centers in northern Taiwan.
Interventions
DRUGurokinase
intrapleural urokinase injection
DRUGplacebo
Normal saline as a placebo for control arm
Sponsors
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Retained hemothorax: it is defined as chest X-ray revealing obvious blood clot in pleural cavity after tube thoracostomy drainage for 3 days. The chest tubes are in good location and have no obstruction. The physician thinks the blood clot is difficult to drain. 2. Age: full 18 year-old
Exclusion criteria
1. Pregnancy 2. Active bleeding 3. Coagulopathy, e.g. congenital or acquired coagulation abnormality, platelet count less than 100,000 /μL, international normalized ratio (INR) more than 1.5, or partial thromboplastin time, PTT, more than 50 seconds after treatment. 4. Cerebrovascular accident within 30 days 5. History of intracranial tumor or vascular abnormality 6. Have received thoracic surgery 7. Have received pleurodesis 8. Wish to receive thoracoscopic surgery for hematoma evacuation directly 9. Allergy to urokinase 10. Sepsis 11. Shock 12. People who are less than 18 years of age, prisoners, aborigines.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| non-surgical rate | about 5 days | Complete response and partial response |
Countries
Taiwan
Outcome results
None listed