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Outcomes of primary image-guided drainage of parapneumonic effusions in children

Ragheed K Mitri1, Stephen D Brown, David Zurakowski

  • 1Division of Cardiovascular and Interventional Radiology, Department of Radiology, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Pediatrics
|September 3, 2002
PubMed

Insights

Image-guided needle aspiration and percutaneous catheter drainage for pediatric parapneumonic effusions showed similar outcomes, but aspiration alone led to higher reintervention rates, especially with low pH and glucose.

Area of Science:

  • Pediatric Pulmonology
  • Interventional Radiology
  • Thoracic Medicine

Background:

  • Parapneumonic effusions are common in children.
  • Image-guided drainage is a standard treatment.
  • Comparing needle aspiration and catheter drainage is crucial for optimal management.

Purpose of the Study:

  • To compare the efficacy of image-guided needle aspiration versus percutaneous catheter drainage for pediatric parapneumonic effusions.
  • To identify predictors of reintervention in children with parapneumonic effusions.

Main Methods:

  • Retrospective chart review of 67 children with parapneumonic effusions.
  • Analysis of medical records, microbiology, and radiology reports.
  • Comparison of outcomes between needle aspiration and pigtail catheter placement.

Main Results:

  • Both drainage methods had similar lengths of stay and complication rates.
  • Reintervention rate was 27%, significantly higher after primary aspiration without catheter.
  • Low pH, fluid loculation, and low glucose levels were predictors of reintervention.

Conclusions:

  • Image-guided needle aspiration and catheter drainage have comparable complication rates and lengths of stay.
  • Primary aspiration without catheter placement increases reintervention risk, particularly in complicated effusions.
  • Consider primary catheter placement for pediatric parapneumonic effusions, guided by on-site pH and glucose monitoring.
Abstract

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