Related Experiment Videos

Intrapleural fibrinolytic treatment of multiloculated pediatric empyemas

R Ulku1, S Onat, N Kiliç

  • 1Thoracic and Cardiovascular Surgery Department, Dicle University School of Medicine, Diyarbakir, Turkey. Refiku@dicle.edu.tr

Minerva Pediatrica
|October 1, 2004
PubMed

Insights

Intrapleural fibrinolytic agents effectively treat pediatric fibrinopurulent empyema but are largely ineffective for chronic empyema. This therapy demonstrated high success rates in the early stage of the condition.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Pharmacology

Background:

  • Empyema, a serious thoracic infection, requires effective treatment strategies.
  • Fibrinopurulent and chronic stages of empyema present distinct therapeutic challenges.
  • Intrapleural fibrinolytic agents offer a potential minimally invasive treatment option.

Purpose of the Study:

  • To evaluate the efficacy of intrapleural fibrinolytic agents (streptokinase, urokinase) in pediatric patients.
  • To compare treatment outcomes between fibrinopurulent and chronic stage empyema.
  • To assess the safety profile of this therapeutic approach.

Main Methods:

  • A cohort of 78 pediatric patients with empyema (36 fibrinopurulent, 42 chronic) received intrapleural fibrinolytic therapy.
  • Streptokinase or urokinase was instilled via chest tube daily for 2-8 days.
  • Treatment success was monitored using chest radiography and computed tomography.

Main Results:

  • The treatment achieved a 91.66% success rate in fibrinopurulent empyema (66.6% complete, 30.55% partial response).
  • In chronic empyema, the therapy was largely ineffective (90.6% failure rate), with only 9.4% showing partial or complete recovery.
  • One patient with fibrinopurulent empyema experienced an allergic reaction and pleural hemorrhage, leading to death.

Conclusions:

  • Intrapleural fibrinolytic treatment is a safe and effective therapy for pediatric patients in the fibrinopurulent stage of empyema.
  • This approach is not recommended for chronic stage empyema due to low efficacy.
  • Further research may explore optimizing fibrinolytic therapy for specific empyema stages.
Abstract

Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...