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[Intrapleural streptokinase in the treatment of complicated parapneumonic empyema]

A Fernández Fernández1, G Giachetto Larraz, G Giannini Fernández

  • 1Unidad Médico-Quirúrgica de Asistencia de Niños con Empiema, Laboratorio de Bioestadística, Departamento de Biofísica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

Anales De Pediatria (Barcelona, Spain : 2003)
|June 23, 2007
PubMed

Insights

Intrapleural streptokinase (STK) offers a safe and effective alternative to surgery for treating complicated parapneumonic empyema in children. This treatment resulted in shorter chest tube drainage durations compared to thoracotomy, with similar hospital stays and no deaths.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • Parapneumonic empyema is a common pediatric hospital admission.
  • A treatment protocol using intrapleural streptokinase (STK) was implemented in 2005 as a surgical alternative.
  • This study evaluates STK for complicated parapneumonic empyema in children.

Purpose of the Study:

  • To assess the efficacy of intrapleural STK in treating pediatric complicated parapneumonic empyema.
  • To compare STK outcomes with those of early thoracotomy.
  • To analyze treatment complications and patient outcomes.

Main Methods:

  • Retrospective and prospective study of children with complicated parapneumonic empyema (2004-2005).
  • Two groups: historical (thoracotomy) and prospective (intrapleural STK).
  • Comparison of chest tube drainage duration, complications, re-admission, length of stay, and mortality.

Main Results:

  • No significant difference in length of hospital stay between groups.
  • Intrapleural STK group had significantly shorter chest tube drainage duration (p < 0.001).
  • Thoracotomy group had a higher rate of partial atypical pneumonectomy (p = 0.051); no deaths in either group.

Conclusions:

  • Intrapleural STK is a viable treatment option for pediatric complicated parapneumonic empyema.
  • STK demonstrates advantages in reduced drainage duration compared to thoracotomy.
  • The study supports STK as a safe alternative with comparable outcomes to surgery.
Abstract

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