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Management of pleural effusion and empyema in a third-level pediatric surgical center

Lucrezia Gentile1, Alessandro Boscarelli2, Manuela Giangreco3

  • 1Faculty of Medicine and Surgery, University of Trieste, Trieste, Italy.

Minerva Pediatrics
|October 31, 2023
PubMed

Insights

A new algorithm improved pediatric pleural effusion and empyema treatment. It reduced imaging, increased ultrasound use, and decreased surgery needs, benefiting children.

Area of Science:

  • Pediatric Surgery
  • Thoracic Medicine
  • Diagnostic Imaging

Background:

  • Pleural effusion and empyema are common pediatric pneumonia complications.
  • Optimal treatment strategies lack robust evidence.

Purpose of the Study:

  • To evaluate a new diagnostic and therapeutic algorithm for pediatric pleural effusion and empyema.
  • To compare outcomes before and after algorithm implementation.

Main Methods:

  • Retrospective study of pediatric patients with pleural effusion/empyema.
  • Comparison of pre- and post-algorithm treatment approaches.
  • Analysis of diagnostic tool use, interventions, complications, and length of stay.

Main Results:

  • Decreased use of chest radiography and computed tomography (CT).
  • Increased utilization of ultrasound for diagnosis.
  • Shift towards urokinase administration via drainage and reduced need for video-assisted thoracoscopic surgery.

Conclusions:

  • The algorithm optimized diagnostic imaging, favoring ultrasound.
  • It led to less invasive treatments and reduced radiation exposure.
  • Implementation resulted in improved management and potentially lower costs.
Abstract

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