{
  "abstract": "Background The MIST2 trial demonstrated fibrinolytics reduce surgery rates and hospital stays in pleural infections, but optimal dosing & timing is unclear.This study compared early (within 24 hours) vs. delayed therapy.Methods Between Nov. 2018 to Oct.2024, consecutive patients with pleural infections were included based on clinical signs (fever or raised inflammatory markers) and pleural fluid criteria (pH<7.2, gram stain positivity, or bacterial growth). All received drainage ± fibrinolytics (Alteplase 10 mg + DNase 5 mg daily for up to 3 days). Group 1 (pre-Nov. 2021) received fibrinolytics after drainage failure; Group 2 (post-Nov. 2021) received fibrinolytics early. Outcomes are listed in table 1.Results Group 1(n=36) and Group 2(n=59) had similar mortality rates (5.56% vs. 5.08%). Group 2 had shorter hospital stays (7.73 vs. 10.92 days, p=0.115) and chest tube durations (4.40 vs.6.20 days,p <0.05).Predicted FVC at 4 months was higher in Group 2 (99.4% vs. 90.5%,p=0.031).Abstract P271 Table 1Conclusions Early fibrinolytic therapy appears to reduce hospital stay and chest tube duration without increasing mortality or requirement for surgery. Further research is needed.",
  "authors": [
    {
      "affiliations": [
        "Kettering General Hospital, Kettering, UK"
      ],
      "name": "Y Rahim"
    },
    {
      "affiliations": [
        "Kettering General Hospital, Kettering, UK"
      ],
      "name": "M Zubair"
    },
    {
      "affiliations": [
        "Glenfield Hospital, Leicester, UK"
      ],
      "name": "H Virk"
    },
    {
      "affiliations": [
        "Kettering General Hospital, Kettering, UK"
      ],
      "name": "M Naeem"
    },
    {
      "affiliations": [
        "Kettering General Hospital, Kettering, UK"
      ],
      "name": "G Tsaknis"
    },
    {
      "affiliations": [
        "Kettering General Hospital, Kettering, UK"
      ],
      "name": "RV Reddy"
    }
  ],
  "title": "P271 Impact of early versus delayed intrapleural fibrinolytics on pleural infection outcomes: an observational study",
  "uid": "f20d81b5-245d-5dfd-a67c-528f6bc897e3"
}