Document Detail


Image-guided catheter drainage of infected pleural effusions.
MedLine Citation:
PMID:  18092294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the safety and efficacy of image-guided drainage of infected pleural effusions. MATERIALS AND METHODS: The clinical outcomes of 93 patients who underwent image-guided drainage of infected pleural effusions between 1998 and 2003 were retrospectively analyzed. Among the 93 patients, 31 (33.3%) were younger than 16 years of age. In all, 129 catheters (8F-14F pigtail catheters) were placed under ultrasonography (US) or computed tomography guidance. In 27 patients (29.0%) intracavitary fibrinolytic therapy with streptokinase was employed to improve drainage. The patients were followed up during daily rounds and, when drainage problems occurred, catheters were exchanged or repositioned. New catheters were placed for undrained loculations. RESULTS: The success, failure, and recurrence rates were 92.5% (86/93), 7.5% (7/93), and 6.4% (6/93), respectively. In the pediatric age group the success rate was significantly higher. Intracavitary fibrinolytic therapy significantly improved daily output, but did not significantly reduce drainage duration or hospital stay. There was no significant difference between the successful and failed treatment cases in terms of US findings, gross appearance, or culture positivity. The only major complication was anaphylactic reaction due to intracavitary instillation of streptokinase (n = 1, 1.1%). The 30-day mortality rate was 2%. CONCLUSION: Image-guided catheter drainage of infected pleural collections is a safe and effective method. Addition of intracavitary fibrinolytic instillation improves drainage, but early intervention prior to collections becoming more complicated remains an important factor in determining prognosis. Non-loculated anechoic collections without septa have a high probability of favorable outcome.
Authors:
Okan Akhan; Orhan Ozkan; Devrim Akinci; Abdulla Hassan; Mustafa Ozmen
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Diagnostic and interventional radiology (Ankara, Turkey)     Volume:  13     ISSN:  1305-3825     ISO Abbreviation:  -     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101241152     Medline TA:  Diagn Interv Radiol     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  204-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Hacetttepe University School of Medicine, Ankara, Turkey. akhano@tr.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Catheterization / instrumentation,  methods,  utilization
Child
Child, Preschool
Drainage / methods,  utilization*
Female
Fibrinolytic Agents / administration & dosage
Humans
Infant
Male
Medical Records
Middle Aged
Pleural Effusion / epidemiology*,  pathology,  radiography,  therapy*,  ultrasonography
Radiography, Interventional / methods,  utilization*
Recurrence
Retrospective Studies
Tomography, X-Ray Computed / utilization
Treatment Outcome
Turkey / epidemiology
Ultrasonography / utilization
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents

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