To investigate the effectiveness of intrapleural heparin or heparin combined with human recombinant DNAase in the treatment of empyema.
Empyema was induced in rabbits using 109 Pasteurella multocida organisms in infusion agar injected via a surgically placed chest tube. Once empyema was verified, a blinded investigator administered drugs via the chest tube. Randomly selected 6 rabbits in each treatment group received either 1000 IU Heparin or 1000 IU heparin plus 1mg human recombinant DNAase via chest tube. Control group (n=6) received 3 ml saline only. The rabbits received treatment every 12 hours for a total of 6 treatments. The animals were sacrificed at day 10 and the amount of empyema and pleural thickening was scored macroscopically on a scale of 0 to 6. All the animals received intramuscular 100,000 U procaine penicilline every 24 hours until sacrifice.
The volume of gross pleural effusion was markedly higher in the heparin group (25.8± 10.7 mL) compared to either saline (8±8.9) or heparin plus human recombinant DNAase (6.8±6.1) groups (p=0.003). Comparison of the mean empyema and pleural thickening scores did not show any significant difference between the groups (p=0.8, p=0.5, respectively). A week correlation found between total volume of aspirated pleural fluid and pleural parameters of white blood cell counts and lactate dehydrogenase levels (r=0.546 and p=0.02, r=0.631 and p=0.02, respectively). One rabbit in saline group died of right heart failure and two rabbits in heparin group died of diarrhea.
The intrapleural administration of either heparin or combination of heparin with human recombinant DNAase is not more effective than saline in the treatment of empyema in rabbits. Intrapleural heparin significantly increased the drainage of pleural fluid compared to combination and saline group.
The intrapleural administration of heparin alone or in combination with human recombinant DNAase is not effective in the treatment of empyema in rabbits.
Moon Na, None.