Tissue Plasminogen Activator
Conditions
Keywords
Chest tube, Thoracostomy, Pleural Diseases, Lung Neoplasms, Pulmonary Embolism, Pneumothorax, Thoracic Surgery, Deoxyribonucleases, Fibrinolytic Agents, Drainage, Pleural Effusion
Brief summary
Chest tubes are used for air or fluid removal from the pleural space. When a chest tube is placed, it can be hard for the fluid to drain.Tissue plasminogen activator (tPA) and DNase are given through the chest tube to help with draining the fluid. We are doing this research to see if early addition of tPA-DNase immediately after chest tube placement will help with better fluid draining.
Detailed description
The purpose of this study is to determine the timing and efficacy of early administration and late administration of t-PA/DNase via thoracostomy (n=60). Patients will be identified from the Intensive Care Unit, Coronary Care Unit, and wards/stepdown units. Prior to chest tube placement, patients will be randomized to one of the two treatment arms (early use of t-PA-DNase verus late use of t-PA-DNase). Route of administration will be via their thoracostomy tube over a period of three days twice daily.
Interventions
COMBINATION_PRODUCTearly tPA and DNase
Early addition of tPA and DNase (immediately at chest tube placement) versus later (24-48 hours) after chest tube placement.
Sponsors
Prisma Health-Midlands
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients, age 18 years or older * Patients with an indication for a thoracostomy tube placement for a pleural effusion
Exclusion criteria
* Patients that require a thoracostomy tube for a pneumothorax * Pregnant women * Sensitivity to t-PA, or DNase * Patients taking carbamazepine or nitroglycerin * Lung volume reduction surgery on side of pleural effusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chest tube removal | 7 days | Time to chest tube removal |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fluid drainage | 3 days | Volume of fluid drained after each tPA and DNase instillation |
| Need for other interventions | 4 days | Post tPA/DNase administration, the need for other interventions, such as surgery or additional chest tube, will be determined. |
| Discharge | 3 weeks | Time to discharge |
Countries
United States
Outcome results
None listed