Effectiveness and Safety of Tissue Plasminogen Activator in the Management of Complicated Parapneumonic Effusions concludes "Early administration of intrapleural tPA seems to be a safe and potentially effective treatment in children with complicated parapneumonic effusions. Randomized controlled trial evidence is needed to confirm this finding."
Dec 30 23.50 tPA lung dilated to 2 ml NS
(time? @ [crossed out] Put 2ml in ob?structed lumen (don't flush)
Leave 2h in site
Pull back thereafter, then flush with NS [normal saline]
Dr. T. Jaecklin
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