Do you give intrapleural lytics for complicated effusion/empyema in patients on systemic anticoagulation?  

Like some people's relationship status, it's complicated. Since 2011, when the MIST II trial (1) was published by Rahman and colleagues, intrapleural tissue plasminogen activator (tpa) and DNase have been given intrapleurally to facilitate source control for pleural infection by breaking up loculat...