Intrapleural Alteplase (TPA) Administration for Empyema / Parapneumonic Effusion

Authors: Kimberly Menzies, Jennifer Oliverio, Laura Bird

Tags: Critical Care, Infectious Diseases, Intrapleural Alteplase, Lung, Pediatric Hospital Medicine, Physicians, Respirology, Surgery

Last Updated: September 5th, 2023

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This document and the linked documents cover the management of complicated pneumonia, specifically outlining the Intrapleural Alteplase (Tissue Plasminogen Activator, aka TPA) administration for when treating Empyema / Parapneumonic Effusion. Since the Covid pandemic we have seen an increase in severe complicated necrotizing bacterial pneumonia due to Group A Streptococcus pyogenes (Group A) and Streptococcus pneumoniae.

Most Recent References

Intrapleural dornase and tissue plasminogen Activator in pediatric empyema (DTPA): a study protocol for a randomized controlled trial. Livingston MH, Mahant S, Ratjen F et al. (2017). Trials 18:293.
Concurrent intrapleural instillation of tissue plasminogen activator and DNase for pleural infection. Majid A, Kheir F, Folch A et al. (2016). Annals American Thoracic Society, 13(9): p1512-1518.
Intrapleural alteplase decreases parapneumonic effusion volume in children more than saline irrigation. Hanson Sj, Havens PL, Simpson PM et al. (2015). Pediatric Pulmonology. 50: 1328-1335.

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Intrapleural Alteplase (TPA) Administration for Empyema / Parapneumonic Effusion

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