[Treatment with intrapleural streptokinase for coagulated hemothorax after cardiac surgery with cardiopulmonary bypass].

INTRODUCTION AND OBJECTIVES

Coagulated hemothorax is a complication of cardiac surgery with cardiopulmonary bypass. The objective of this study was to present the authors' experience in the intrapleural infusion of streptokinase for the treatment of this complication.

METHODS

From January 1996 to June 1999, nine patients (6 males, 3 females, age range: 1-75 years) were clinically and radiographically diagnosed with coagulated hemothorax after cardiac surgery. All patients were treated with intrapleural infusion of streptokinase at a standard dose of 250,000 units in adult patients and 12,000 U/kg in pediatric cases. In cases of occluded chest drainage, the position of the patient was changed and drainage was opened.

RESULTS

In all the cases clinical and radiological improvement was observed and 100 to 200 ml of hemothorax was obtained on drainage. One patient died of multiorgan failure due to the underlying disease not related to the procedure. No alteration were observed in hematological tests including coagulation. The other 8 patients were discharged from hospital and remain without pulmonary compromise to date.

CONCLUSION

Treatment of coagulated hemothorax with intrapleural infusion of streptokinase is a useful procedure and avoid the need for surgical drainage of hemothorax.