Q: Intrapleural administration of fibrinolytics cause systemic thrombolysis. True or False?


Answer: False

Intrapleural administration of fibrinolytic agents has been used commonly to improve drainage of loculated parapneumonic effusions and empyemas. Literature is a mix bag of its benefit. Concern is always raised about possible systemic thrombolysis. but studies have confirmed that intrapleural administration of fibrinolytics does not cause systemic thrombolysis.


References:

1. Gervais DA, Levis DA, Hahn PF, et al. Adjunctive intrapleural tissue plasminogen activator administered via chest tubes placed with imaging guidance: effectiveness and risk for hemorrhage. Radiology 2008; 246:956. 

2. Davies CW, Lok S, Davies RJ. The systemic fibrinolytic activity of intrapleural streptokinase. Am J Respir Crit Care Med 1998; 157:328.