Utilidad de la urocinasa en derrames pleurales multiloculados
Use of urokinase to treat multiloculated pleural effusion
J. Casanova Viúdez*, J.M. Izquierdo Elena, J. Pac Ferrer, M. Mariñán Gorospe, R. Rojo Marcos, J.C. Rumbero Sánchez, F. Vara Cuadrado
Servicio de Cirugía Torácica. Hospital de Cruces. Baracaldo. Vizcaya
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"apellidos" => "Casanova Viúdez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Izquierdo Elena" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Pac Ferrer" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Mariñán Gorospe" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Rojo Marcos" ] 5 => array:2 [ "nombre" => "J.C." "apellidos" => "Rumbero Sánchez" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Vara Cuadrado" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía Torácica. Hospital de Cruces. Baracaldo. Vizcaya" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Cirugía Torácica. Hospital de Cruces. Plaza de Cruces, s/n. Baracaldo. 48903 Vizcaya." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of urokinase to treat multiloculated pleural effusion" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1994-06-14" "fechaAceptado" => "1994-10-04" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec546479" "palabras" => array:2 [ 0 => "Derrame pleural" 1 => "Urocinasa" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec546478" "palabras" => array:2 [ 0 => "Pleural effusion" 1 => "Urokinase" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comprobada la eficacia de la urocinasa como agente trombolítico y proteolítico, los autores valoran la utilidad de ésta en el tratamiento de los derrames pleurales multiloculados, así como de empiemas y hematomas, con el fin de evitar otras técnicas más agresivas.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el presente estudio clínico 18 casos consecutivos en los que se utilizó el mencionado tratamiento. El criterio de inclusión fue sonda torácica bien colocada, que no drenaba y con imagen radiológica de ocupación. Se excluyeron expresamente las fístulas bronquiales y los hemotórax de menos de 7 días de evolución. La etiología de los derrames fue posneumónica, posquirúrgica y postraumática. El tratamiento se aplicó durante 3-4 días. Como criterios de eficacia se utilizaron el volumen de líquido drenado y la evolución de la imagen radiológica.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La cantidad de líquido drenada fue muy variable (media, 1.282, DT, 1.224; rangos, 100-3.975). La evolución radiológica se consideró completamente satisfactoria en 10 casos, quedando en 6 pacientes una ocupación del seno costofrénico sin repercusión clínica. Hubo dos fallecimientos, pero no se relacionaron con la administración del fármaco. Se diagnosticaron dos recidivas de escasa entidad, que no precisaron repetir el tratamiento con urocinasa. El seguimiento de los pacientes a un mínimo de 30 días tras el alta hospitalaria no ha encontrado nuevas recidivas.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los autores han encontrado utilidad en el uso de urocinasa como agente fibrinolítico en el caso de los derrames multiloculados, con escasas contraindicaciones, por lo que debería ser considerado de primera elección antes que otras medidas terapéuticas más agresivas.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Recognizing the confirmed efficacy of urokinase as a thrombolytic and proteolytic agent, we assess its usefulness in the treatment of multiloculated pleural effusion, empyema and hematoma as a substitute of other more invasive procedures.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Treatment with urokinase was applied in 18 consecutive cases. Inclusion criteria were a well-placed thoracic probe that did not drain and a radiological image showing occupation. Patients were excluded if they had bronchial fistulas or hemothorax of less than 7 days duration. Effusion in the included cases had developed after pneumonia, after surgery or after trauma. Treatment lasted 3 to 4 days ant was considered effective or not based on the volume of liquid drained and on radiological evidence of change.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The amount of liquid drained was highly variable (mean 1,282 and S.D. 1,224; range 100-3,975). Radiological change was considered completely satisfactory in 10 cases, with 6 patients continuing to show occupation of the costophrenic sinus with no clinical repercussions. Two patients died of causes unrelated to administration of the drug. There were two mild relapses that did not require a second round of treatment with urokinase. Patients were followed for a least 30 days after discharge and no new recurrences were detected.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We have found urokinase to be a useful fibrinolytic agent for treating multiloculated effusion. Contraindications are few and therefore urokinase should be considered the first-choice treatment to be applied before other more invasive measures are taken.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modern management of adult thoracic empyema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Lemmer" 1 => "M. Bothman" 2 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 8 | 14 |
| 2024 October | 63 | 42 | 105 |
| 2024 September | 66 | 32 | 98 |
| 2024 August | 78 | 68 | 146 |
| 2024 July | 50 | 32 | 82 |
| 2024 June | 82 | 39 | 121 |
| 2024 May | 66 | 35 | 101 |
| 2024 April | 59 | 37 | 96 |
| 2024 March | 65 | 45 | 110 |
| 2024 February | 40 | 58 | 98 |
| 2024 January | 0 | 27 | 27 |
| 2023 December | 0 | 29 | 29 |
| 2023 November | 0 | 34 | 34 |
| 2023 October | 0 | 35 | 35 |
| 2023 September | 0 | 17 | 17 |
| 2023 August | 0 | 6 | 6 |
| 2023 July | 0 | 31 | 31 |
| 2023 June | 0 | 13 | 13 |
| 2023 May | 0 | 3 | 3 |
| 2023 April | 0 | 2 | 2 |
| 2023 March | 10 | 5 | 15 |
| 2023 February | 57 | 28 | 85 |
| 2023 January | 48 | 35 | 83 |
| 2022 December | 67 | 38 | 105 |
| 2022 November | 55 | 22 | 77 |
| 2022 October | 38 | 33 | 71 |
| 2022 September | 34 | 27 | 61 |
| 2022 August | 31 | 41 | 72 |
| 2022 July | 26 | 29 | 55 |
| 2022 June | 36 | 28 | 64 |
| 2022 May | 35 | 31 | 66 |
| 2022 April | 45 | 37 | 82 |
| 2022 March | 26 | 40 | 66 |
| 2022 February | 30 | 31 | 61 |
| 2022 January | 32 | 37 | 69 |
| 2021 December | 33 | 50 | 83 |
| 2021 November | 39 | 52 | 91 |
| 2021 October | 24 | 47 | 71 |
| 2021 September | 21 | 45 | 66 |
| 2021 August | 13 | 35 | 48 |
| 2021 July | 14 | 32 | 46 |
| 2021 June | 28 | 59 | 87 |
| 2021 May | 17 | 47 | 64 |
| 2021 April | 45 | 62 | 107 |
| 2021 March | 38 | 27 | 65 |
| 2021 February | 35 | 28 | 63 |
| 2021 January | 30 | 22 | 52 |
| 2020 December | 25 | 22 | 47 |
| 2020 November | 22 | 32 | 54 |
| 2020 October | 39 | 14 | 53 |
| 2020 September | 15 | 16 | 31 |
| 2020 August | 38 | 18 | 56 |
| 2020 July | 32 | 19 | 51 |
| 2020 June | 22 | 18 | 40 |
| 2020 May | 17 | 19 | 36 |
| 2020 April | 21 | 13 | 34 |
| 2020 March | 25 | 18 | 43 |
| 2020 February | 32 | 29 | 61 |
| 2020 January | 42 | 22 | 64 |
| 2019 December | 36 | 35 | 71 |
| 2019 November | 15 | 21 | 36 |
| 2019 October | 26 | 14 | 40 |
| 2019 September | 31 | 17 | 48 |
| 2019 August | 26 | 11 | 37 |
| 2019 July | 40 | 26 | 66 |
| 2019 June | 76 | 24 | 100 |
| 2019 May | 56 | 25 | 81 |
| 2019 April | 36 | 29 | 65 |
| 2019 March | 14 | 26 | 40 |
| 2019 February | 6 | 7 | 13 |
| 2019 January | 11 | 11 | 22 |
| 2018 December | 8 | 19 | 27 |
| 2018 November | 16 | 18 | 34 |
| 2018 October | 17 | 12 | 29 |
| 2018 September | 8 | 14 | 22 |
| 2018 May | 3 | 1 | 4 |
| 2018 April | 7 | 6 | 13 |
| 2018 March | 4 | 6 | 10 |
| 2018 February | 7 | 12 | 19 |
| 2018 January | 6 | 8 | 14 |
| 2017 December | 12 | 15 | 27 |
| 2017 November | 12 | 9 | 21 |
| 2017 October | 8 | 14 | 22 |
| 2017 September | 7 | 6 | 13 |
| 2017 August | 11 | 11 | 22 |
| 2017 July | 3 | 7 | 10 |
| 2017 June | 10 | 14 | 24 |
| 2017 May | 12 | 13 | 25 |
| 2017 April | 5 | 4 | 9 |
| 2017 March | 7 | 22 | 29 |
| 2017 February | 2 | 8 | 10 |
| 2017 January | 3 | 6 | 9 |
| 2016 December | 6 | 13 | 19 |
| 2016 November | 15 | 14 | 29 |
| 2016 October | 20 | 18 | 38 |
| 2016 September | 20 | 17 | 37 |
| 2016 August | 12 | 3 | 15 |
| 2016 July | 19 | 5 | 24 |
| 2016 June | 21 | 8 | 29 |
| 2016 May | 10 | 4 | 14 |
| 2016 April | 16 | 0 | 16 |
| 2016 March | 8 | 0 | 8 |
| 2016 February | 8 | 0 | 8 |
| 2016 January | 26 | 10 | 36 |
| 2015 December | 21 | 12 | 33 |
| 2015 November | 30 | 6 | 36 |
| 2015 October | 7 | 2 | 9 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 1 | 0 | 1 |
| 2015 June | 1 | 0 | 1 |
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