Prospective evaluation of lung function in children with parapneumonic empyema
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Updated: Jan 31, 2026
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Published on: August 9, 2024
Fernando M de Benedictis1, Ines Carloni2, Patrizia Osimani2
1Salesi Children's Hospital Foundation, Ancona, Italy.
Insights
Childhood empyema generally has a good respiratory outcome. Lung function in children with empyema returns to normal, regardless of treatment type, with most showing full recovery within months.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Infectious Diseases
Background:
- Limited prospective studies exist on childhood empyema outcomes.
- Childhood empyema necessitates understanding long-term respiratory effects.
Purpose of the Study:
- To compare the pulmonary function outcomes in children diagnosed with empyema.
- To assess the impact of different interventions on lung function recovery.
Main Methods:
- A longitudinal study of 39 children (median age 4.6 years) with empyema.
- Pulmonary function tests and radiographic imaging were used for follow-up.
- Interventions included chest tube drainage and video-assisted thoracoscopic surgery.
Main Results:
- All 35 children who completed follow-up achieved normal lung function.
- Mild-to-moderate lung function defects resolved within 2-57 months.
- No significant difference in recovery time was observed between treatment groups.
Conclusions:
- The respiratory outcome for childhood empyema is generally favorable.
- Lung function recovery is not significantly influenced by the intervention method.
- Most children experience complete pulmonary function normalization post-empyema.
Rationale:
Prospective studies that evaluated the outcome of childhood empyema are limited.
Objective:
To compare the outcome of pulmonary function in children with empyema.
Patients And Methods:
Children discharged with a diagnosis of empyema underwent a longitudinal study including measurement of pulmonary function and radiographic imaging.
Results:
The population consisted of 39 patients, 24 males, and 15 females; with a median age of 4.6 years. Etiology was defined in 20/39 patients, and predominant microorganism was Streptococcus pneumoniae (19/20 isolates). Chest tube drainage with or without fibrinolytic agents was the primary intervention in 25 children. Video-assisted thoracoscopic surgery was performed in 14 and 5 children as primary and secondary intervention, respectively. Thirty-five children completed the lung function follow-up. At first follow-up visit, 5 out of 17 children able to perform spirometry (initially collaborating children) had normal tests, and 12 had mild-to-moderate defects of lung function that returned to normal over 2-57 months. Eighteen children unable to perform spirometry at first follow-up visit (initially non-collaborating children) had normal tests when they were evaluated 5-78 months postdischarge. At the end of the follow-up, all patients had normal lung function. Time to normalize did not differ between groups receiving different treatments (initially collaborating children, P = 0.064; initially non-collaborating children P = 0.223). Three previously healthy children had recurrent cough, and all children had normal chest radiographs aside from pleural thickening.
Conclusions:
The respiratory outcome in children with empyema is generally good and is not influenced by the type of intervention.
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