The Risks and Benefits of Combination Enzymatic Therapy

There's not a huge concern about systemic absorption of the TPA or systemic bleeding from plural administration, but there certainly is a risk for interplural hemorrhage. I tend to be fairly cautious in patients who are coagulopathy either because of their on-enticoagulation or their coagulopathic for some other reason. In those patients, I may be reluctant to give them full dose enzymatic therapy. DFK, correct me if I'm wrong. But I think, generally, the data will suggest it's safe.