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CASE REPORT
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 122-125

Tissue plasminogen activator and pulmozyme for postoperative-retained hemothorax: A safe alternative to postoperative re-exploration


Department of Surgery, Summa Akron City Hospital, Akron, OH, USA

Correspondence Address:
Melissa Pastoressa
Department of Surgery, Summa Akron City Hospital, 525 E Market St., Akron, OH 44304
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5151.207741

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Successful treatment of traumatic hemothoraces is imperative to reduce morbidity and mortality among patients. Treatment modalities range from more conservative to invasive measures, including antibiotic therapy, thoracostomy tube placement, video-assisted thoracoscopic surgery, or thoracotomy. Various studies have documented success in using fibrinolytics such as tissue plasminogen activator (tPA) in conjunction with deoxyribonuclease administered through a chest tube to resolve a hemothorax. The optimal dose and frequency of fibrinolytic therapy have not yet been determined although most studies report administering therapy two times a day for 3 days. We report a successful case of a one-time dose of fibrinolytic therapy through thoracostomy tube which could support that a single dose may be ideal and sufficient enough to resolve a hemothorax. We also performed this in the acute postoperative period, which has not been well studied, and believe fibrinolytic therapy can be safe to use in this setting.


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