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Intrapericardial streptokinase for purulent pericarditis
1Department of Cardiovascular Surgery, Yüzüncü Yil University School of Medicine, 65200 Van, Turkey.
Surgery Today
|June 29, 2004
Summary
This study shows that using streptokinase with antibiotics and drainage is a safe and effective treatment for purulent pericarditis in children, helping to prevent constrictive pericarditis.
Area of Science:
- Cardiology
- Pediatric Medicine
- Infectious Diseases
Background:
- Purulent pericarditis is a rare but serious condition.
- Antibiotics and surgical drainage are standard treatments.
- Loculations and fibrin strands can complicate drainage.
Purpose of the Study:
- To evaluate the safety and efficacy of intrapericardial streptokinase in children with purulent pericarditis.
- To assess streptokinase's ability to obliterate loculations and fibrin strands.
- To determine if this method prevents constrictive pericarditis.
Main Methods:
- Nine children (3–13 years) with purulent pericarditis were treated.
- Treatment involved pericardial drainage, antibiotics, and streptokinase instillation.
- Data collected included effusion volume, hemodynamic changes, and adverse events.
Main Results:
- All patients had purulent pericardial effusion (180-650 ml).
- Evacuation of empyema led to increased blood pressure and decreased central venous pressure.
- No systemic bleeding, arrhythmias, or anaphylactic reactions were observed.
Conclusions:
- Intrapericardial streptokinase is safe and effective for dissolving fibrin and loculations.
- Complete pericardial drainage was achieved in all patients.
- Streptokinase instillation is recommended to prevent constrictive pericarditis.