Related Experiment Video
Updated: Aug 13, 2026
13:27
Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
Rational treatment of empyema in children
A H Meier1, B Smith, A Raghavan
1Division of Pediatric Surgery, Stanford University, 725 Welch Rd, Palo Alto, CA 94304, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|August 2, 2000
Summary
Pediatric empyema treatment is effective and cost-efficient using thoracostomy tube drainage (TTD) with or without fibrinolytic therapy (FT). Advanced cases may benefit from video-assisted thoracoscopic debridement (VATD), with imaging guiding treatment decisions.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Medical Imaging
Background:
- Pediatric empyema requires effective and cost-efficient treatment strategies.
- Current therapeutic options include thoracostomy tube drainage (TTD) with or without fibrinolytic therapy (FT), and video-assisted thoracoscopic debridement (VATD).
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of different treatment protocols for pediatric empyema based on radiographic appearance.
- To determine the optimal timing and modality for intervention in pediatric empyema cases.
Main Methods:
- Retrospective case series conducted at a tertiary referral center.
- Analysis of 31 children treated between 1995 and 1999.
- Comparison of outcomes and costs for TTD (with or without FT) versus VATD.
Main Results:
- TTD with or without FT was successful in most pediatric empyema cases (85.2%).
- Salvage VATD was required in 14.8% of TTD cases, with higher associated costs and length of stay.
- Primary VATD was performed in 12.9% of cases, demonstrating shorter hospital stays and lower overall charges compared to salvage VATD.
- Complications were minimal, with no significant adverse events related to urokinase therapy.
Conclusions:
- TTD with or without FT is a safe and effective first-line treatment for early-stage pediatric empyema.
- Primary VATD is recommended for children with advanced disease.
- An algorithmic approach utilizing imaging (CT or ultrasonography) can improve prediction of treatment failure and optimize cost-effectiveness.
Related Concept Videos
01:30Acute Pharyngitis
Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:26Tonsillitis II: Management
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:29Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...