Use of Tissue Plasminogen Activator in Abdominal Abscesses in Children—A Single-Center Randomized Control Trial
| Autor: | Jacob C. Langer, Dimitri A. Parra, Nicholas Armstrong, Michael Temple, Bairbre Connolly, Simal Goman, Afsaneh Amirabadi, Joao G. Amaral, Craig Gibson, Philip John |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Abdominal Abscess Time Factors Adolescent Single Center Tissue plasminogen activator 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Fibrinolytic Agents Randomized controlled trial law medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Child business.industry General Medicine Length of Stay Surgery Treatment Outcome Child Preschool Tissue Plasminogen Activator 030220 oncology & carcinogenesis Drainage Female business medicine.drug |
| Zdroj: | Canadian Association of Radiologists Journal. 72:577-584 |
| ISSN: | 1488-2361 0846-5371 |
| Popis: | Purpose: To establish the efficacy of once-per-day intracavitary tissue plasminogen activator (tPA) in the treatment of pediatric intra-abdominal abscesses. Methods: A single-center prospective, double-blinded, randomized controlled trial of the use of intracavitary tPA in abdominal abscesses in children. Patients were randomized to either tPA-treatment or saline-treatment groups. Primary outcome was drainage catheter dwell (hours). Secondary outcomes were length of hospital stay, times to discharge, clinical and sonographic resolution, and adverse events (AEs). Results: Twenty-eight children were randomized to either group (n = 14 each). Demographics between groups were not significantly different (age P = .28; weight P = .40; gender P = .44). There were significantly more abscesses in the tPA-treated group ( P = .03). Abscesses were secondary to perforated appendicitis (n = 25) or postappendectomy (n = 3). Thirty-four abscesses were drained, 4 aspirated, 3 neither drained/aspirated. There was no significant difference in number of drains ( P = .14), drain size ( P = .19), primary outcome ( P = .077), or secondary outcomes found. No procedural or intervention drug-related AEs occurred. No patient in the saline-treated group required to be switched/treated with tPA. Conclusion: No significant difference in the length of catheter dwell time, procedure time to discharge, or time to resolution was found. Intracavitary tPA was not associated with morbidity or mortality. The results neither support nor negate routine use of tPA in the drainage of intra-abdominal abscess in children. It is possible that a multicentre study with a larger number of patients may answer this question more definitively. |
| Databáze: | OpenAIRE |
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