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Table 4 Summary of results of literature review

From: Life-threatening pleural hemorrhage following intrapleural enzyme therapy and successful treatment with fibrin-thrombin sealant pleurodesis: a case report

Study Study type Sample Intrapleural therapy used Anticoagulation or antiplatelet use Hemorrhagic complications
Thommi et al. 2012 [11] Single centre placebo controlled randomized controlled trial 68 adults Placebo or alteplase Unspecified Hemorrhage requiring transfusion in two patients
Rahman et al. 2011 [5] Multicentre placebo controlled randomized trial 210 adults Placebo or alteplase or DNase or alteplase + DNase Unspecified Two intrapleural hemorrhages and one hemoptysis in alteplase + DNase group. Two episodes of gastrointestinal bleeding in the DNase group.
Maskell et al. 2005 [4] Multi-centre placebo controlled randomized trial 427 adults Placebo or streptokinase Unspecified Seven hemorrhages (local or systemic) in streptokinase group, six in placebo group
Nie et al. 2014 [10] Meta-analysis of randomized trials 879 adults, 98 children Placebo, streptokinase, urokinase, tPA Unspecified Nonsignificant increase in severe side effects
Piccolo et al. 2014 [13] Retrospective observational study 107 adults tPA and DNase Unfractionated heparin × 1, chronic liver disease and ↑prothrombin time × 1 Hemorrhage requiring transfusion in two patients
Anevlavis et al. 2011 [7] Case series Two adults Alteplase Therapeutic dose tinzaparin (14,000 IU), Prophylactic tinzaparin (3500 IU) Two massive pleural hemorrhages
Chai and Kuan, 2011 [17] Case report One adult Streptokinase Nil Massive pleural hemorrhage
Goralski et al. 2009 [9] Case report and literature review One adult Alteplase Nil Severe pleural hemorrhage
Gervais et al. 2008 [12] Retrospective observational study 66 adults Alteplase Warfarin × 1, low-molecular-weight heparin (dalteparin 5000U TDS) × 2, unfractionated heparin × 1 Five major pleural hemorrhages in four patients who were anticoagulated. No hemorrhage in those receiving prophylactic anticoagulation or clopidogrel
Ruiz et al. 2006 [8] Case report One adult Alteplase Nil Massive pleural hemorrhage
  1. DNase deoxyribonuclease, tPA tissue plasminogen activator