Role of Intrapleural Instillation of Mesna for Adhesiolysis in Multiloculated Pleural Effusion and Empyema
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
The management of Multiloculated pleural effusion and empyema with closed pleural aspiration and intercostal tube drainage fails most of the time due to the presence of thick viscous fluid and multiple septations . We extra plot that MESNA (2-mercaptoethane sulfonate Na) is an agent which is easily available, effective, safe and less expensive and due to its proved action as a mucolytic, chemical dissector and fibrinolytic along with our practical experience, we propose the hypothesis that MESNA can be an intrapleuralfibrinolytic agent which can overcome many limitation of presently available agents. Materials and Methods: It was a Hospital based prospective type of interventional study. Results: The present study was undertaken on 40 clinically and radio logically diagnosed patients of multiloculated pleural effusion (n= 20) and empyema (n=20). Septations were devided in to thin and thick septa as well as few and multiple septations. With instillation of MESNA, there was decrease in multiple septations on Day 1,2, and 3 in both groups and this change in number of septations was found to be statistically significant in both the groups (p<0.001). With instillation of MESNA there was decrease in thick septations on Day 1,2, and 3 in both groups and this change in thickness of septations was found to be statistically significant in both the groups (p<0.001). In Effusion group patient’s, complete resolution was seen in 12 (60%), partial resolution seen in 2 (10%) and 6 (30%) patients still had no resolution. While in empyema patients only 6 (30%) patients had complete resolution, 10 (50%) had partial resolution and 4 (20%) of patients in empyema group had no resolution. This difference in resolution among the two groups was found to be statistically significant (p=0.021). Conclusion: MESNA is a safe drug for intrapleural instillation. Fibrinolytics activity of MESNA is good and it is effective both in multiloculated pleural effusion and empyema. MESNA Can be used as primary intrapleural agent where facility of thoracoscopy and VATS are not available.
Authors and Affiliations
Rajendra kumar chandel, Chand Bhandari, Shivraj Sharma, Ambika Sharma
Keywords
Related Articles
- EP ID EP574538
- DOI 10.9790/0853-1804133644.
- Views 44
- Downloads 0
Assessment of Different Risk Factors Affecting Pulmonary Tuberculosis among Sudanese Patients
Several risk factors have been proofed to have strong relation with the emergence and existence of pulmonary tuberculosis worldwide, these include poverty, malnutrition, overcrowding, smoking, gender, age, migration and...
Prevalence of Hyponatremia in Children with Pneumonia -Cross- Sectional Study
Pneumonia remains the leading single cause of childhood mortality. It’s associated with several complications and the commonest metabolic complication being hyponatremia. Studies done in the western countries have report...
A Case Report of Hyper Pigmented Patch Over the Posterior Vaginal wall – Supra Basal Bullous
The presence of hyperpigmented sessile polypoid growth present over the posterior vaginal wall, which was found to be an incidental finding in a woman of reproductive age group during regular gynecological examination. T...
Outcomes after phacoemulsification surgery in eyes with white mature cataracts: Results from a Military Hospital in Western India
Background: The aim of this study was to assess the postoperative visual outcomes of phacoemulsification in patients with white mature cataract from a western Indian population who were operated in a military Hospital fr...
Case Report- Cytological Diagnosis of Anaplastic Carcinoma of Thyroid- A Rare Finding
Anaplastic thyroid carcinoma [ATC] is one of the most aggressive of all human malignant diseases. It is a rare tumour accounting for 1% to 2% of all thyroid carcinomas. As the tumour presents at very advanced stage ATC i...