Treatment of encapsulated pleural effusions in children: a prospective trial
| Autor: | Jiri, Kobr, Katerina, Pizingerova, Lumir, Sasek, Jiri, Fremuth, Konrad, Siala, Jaroslav, Racek |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Adolescent Injections Intralesional Risk Assessment Severity of Illness Index Fibrinolytic Agents Pneumonia Bacterial Humans Streptokinase Prospective Studies Child Empyema Pleural Ultrasonography Infant Length of Stay Combined Modality Therapy Anti-Bacterial Agents Hospitalization Pleural Effusion Logistic Models Treatment Outcome Chest Tubes Child Preschool Multivariate Analysis Drainage Female Follow-Up Studies |
| Zdroj: | Pediatrics international : official journal of the Japan Pediatric Society. 52(3) |
| ISSN: | 1442-200X |
| Popis: | The aim of this study was to improve the efficacy of treatment of complicated pleural effusions.In this prospective study, 76 consecutive children (average age 5.0 +/- 4.14 years) fulfilling the required classification criteria were duly treated with chest tube placement and divided into two groups depending on the presence of encapsulated or non-encapsulated effusions. Treatment of the former group was supplemented by intrapleural fibrinolysis. The effectiveness of treatment was assessed in terms of chest tube dwell-time and total length of hospitalization. Regression analysis was performed using independent factors that were associated with these dependent factors. Value differences for P0.05 were considered significant.The ultrasound pleural distance and lactic-dehydrogenase content in the pleural fluid was significantly associated with the length of treatment (P0.01). Improved response to treatment, reduced duration of hospitalization (9.2 +/- 1.9 vs 11.5 +/- 0.9; P0.01) and tube dwell-time (7.6 +/- 1.3 vs 9.5 +/- 0.9; P0.01) was achieved in the intrapleural-fibrinolysis-treated group (n= 38) compared with controls (n= 38), with virtually the same total tube output (606.1 +/- 257.5 vs 673.1 +/- 347.4; P= 0.175). All patients were completely cured. Following 104 applications of the fibrinolytic agent there was one change in coagulation parameters: hypofibrinogenemia (in 1%).The authors recommend intrapleural fibrinolysis as an effective and safe alternative treatment strategy in treating encapsulated pleural effusions in children. |
| Databáze: | OpenAIRE |
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