Management of parapneumonic pleural effusion in children: Is there a role for corticosteroids when conventional nonsurgical management fails? A single‐center 15‐year experience
| Autor: | Frédéric Piérart, André Mulder, Matthieu Thimmesch, Isabelle Loeckx, Frédéric Lebrun, Pierre Demaret, Caroline Genin |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pleural effusion medicine.medical_treatment Single Center Parapneumonic effusion Adrenal Cortex Hormones Interquartile range Thoracoscopy medicine Humans Child Empyema Pleural Retrospective Studies medicine.diagnostic_test business.industry medicine.disease Empyema Surgery Pleural Effusion Chest tube Pneumonia Chest Tubes Child Preschool Pediatrics Perinatology and Child Health business |
| Zdroj: | Pediatric Pulmonology. 57:245-252 |
| ISSN: | 1099-0496 8755-6863 |
| DOI: | 10.1002/ppul.25699 |
| Popis: | OBJECTIVE Description of the use of corticosteroids for the management of parapneumonic pleural effusion in children. METHODS Retrospective single-center observational study of all children hospitalized with a diagnosis of parapneumonic pleural effusion during a 15-year period. RESULTS We documented 97 cases of parapneumonic effusion during the study period, with a median age (interquartile range [IQR]) of 43 (33-61) months. Most of the children benefited from an evacuation of the pleural effusion (89/97, 91.8%): 21 patients (21.6%) were treated with needle thoracocentesis only, while a chest tube was inserted in 68 children (70.1%). Thirty-two patients (33%) were treated with intrapleural fibrinolysis. Fifty-five children (56.7%) received corticosteroids for persistent fever. The median time (IQR) between hospital admission and initiation of corticosteroids was 5.5 (4-7) days. When corticosteroids were initiated, children had been febrile for 9 (IQR: 8-11) days. The fever ceased in a median (IQR) of 0 (0-1) day after corticosteroids initiation. Only one patient required a video-assisted thoracoscopy that was necessary for morphological reasons (morbid obesity). No children treated with corticosteroids required surgery. All children were discharged from hospital. The median (IQR) hospital length of stay was 11 (8-14) days, with no difference between children with and those without corticosteroids. CONCLUSION Our findings indicate that corticosteroids may be a part of the therapeutic armamentarium for children with parapneumonic effusion when conventional nonsurgical management fails. |
| Databáze: | OpenAIRE |
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