{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:43:19Z","timestamp":1790739799922,"version":"4.1.0"},"reference-count":9,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pleural infection is an important clinical problem with significant morbidity. In poorly draining complex pleural effusions, the current management favours a less invasive image\u2010guided placement of smaller bore catheters and adjunctive intrapleural fibrinolysis therapy (IPFT). We describe our experience of using IPFT in three patients with different bleeding risks with complex pleural effusions. The first was a 30\u2010year\u2010old with transfusion\u2010dependent \u03b2\u2010thalassemia with haemoglobin of 7.8 g\/dL; second was an 87\u2010year\u2010old on dabigatran with haemoglobin of 10 g\/dL; and the third was an 80\u2010year\u2010old with diffuse large B\u2010cell lymphoma with haemoglobin of 8.6 g\/dL. All three patients received three doses of alteplase and deoxyribonuclease (DNase) without any adverse effects of bleeding and had resolution of the effusion. This case series is an addition to the current literature on the safety of IPFT and we highlight the use of IPFT in patients with low baseline haemoglobin and on anticoagulation therapy.<\/jats:p>","DOI":"10.1002\/rcr2.648","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T13:39:38Z","timestamp":1598362778000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Short\u2010course intrapleural alteplase and <scp>DNase<\/scp> in complex effusion with bleeding risk"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-1055","authenticated-orcid":false,"given":"Xiong Khee","family":"Cheong","sequence":"first","affiliation":[{"name":"Respiratory Unit University Kebangsaan Malaysia Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3788-4789","authenticated-orcid":false,"given":"Andrea","family":"Yu\u2010Lin Ban","sequence":"additional","affiliation":[{"name":"Respiratory Unit University Kebangsaan Malaysia Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-361X","authenticated-orcid":false,"given":"Mohamed Faisal","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Respiratory Unit University Kebangsaan Malaysia Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200510-113JH"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102046"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012740"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.137000"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201407-329OC"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000387"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001887"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70182-6"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0706"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.648","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.648","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.648","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T15:27:52Z","timestamp":1693841272000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,25]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1002\/rcr2.648"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.648","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,25]]},"assertion":[{"value":"2020-06-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00648"}}