Empyema Treated With tPA & DNAse

Prospective Randomized Trial: Fibrinolysis With tPA (Tissue Plasminogen Activator) Versus tPA and DNAse in Children With Empyema

The objective of this study is to scientifically evaluate a new substrate for fibrinolysis compared to our standard tPA.

The hypothesis, driven by a recent prospective trial, is that tPA may benefit from the addition of DNAse.

The primary outcome variable between the two techniques will be length of hospitalization after initiation of treatment.

Inclusion Criteria:

Patients less than 18 years of age requiring an intervention for empyema by one of the following:

• Septation or loculation seen on ultrasound or computed tomography or
• Greater than 10,000 white blood cells identified on pleural tap

Exclusion Criteria:

• Immunodeficiency process
• Secondary diagnosis or condition that will keep them in the hospital beyond the empyema
• Existing contraindications to chest tube
• Documented allergy to one of the study medications