| Treatment of encapsulated pleural effusions in children: a prospective trial. | |
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MedLine Citation:
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PMID: 19919636 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The aim of this study was to improve the efficacy of treatment of complicated pleural effusions. METHODS: In this prospective study, 76 consecutive children (average age 5.0 +/- 4.14 years) fulfilling the required classification criteria were duly treated with chest tube placement and divided into two groups depending on the presence of encapsulated or non-encapsulated effusions. Treatment of the former group was supplemented by intrapleural fibrinolysis. The effectiveness of treatment was assessed in terms of chest tube dwell-time and total length of hospitalization. Regression analysis was performed using independent factors that were associated with these dependent factors. Value differences for P < 0.05 were considered significant. RESULTS: The ultrasound pleural distance and lactic-dehydrogenase content in the pleural fluid was significantly associated with the length of treatment (P < 0.01). Improved response to treatment, reduced duration of hospitalization (9.2 +/- 1.9 vs 11.5 +/- 0.9; P < 0.01) and tube dwell-time (7.6 +/- 1.3 vs 9.5 +/- 0.9; P < 0.01) was achieved in the intrapleural-fibrinolysis-treated group (n= 38) compared with controls (n= 38), with virtually the same total tube output (606.1 +/- 257.5 vs 673.1 +/- 347.4; P= 0.175). All patients were completely cured. Following 104 applications of the fibrinolytic agent there was one change in coagulation parameters: hypofibrinogenemia (in 1%). CONCLUSIONS: The authors recommend intrapleural fibrinolysis as an effective and safe alternative treatment strategy in treating encapsulated pleural effusions in children. |
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Authors:
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Jiri Kobr; Katerina Pizingerova; Lumir Sasek; Jiri Fremuth; Konrad Siala; Jaroslav Racek |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-16 |
Journal Detail:
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Title: Pediatrics international : official journal of the Japan Pediatric Society Volume: 52 ISSN: 1442-200X ISO Abbreviation: Pediatr Int Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-12-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100886002 Medline TA: Pediatr Int Country: Australia |
Other Details:
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Languages: eng Pagination: 453-8 Citation Subset: IM |
Affiliation:
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Department of Paediatrics-PICU, Faculty of Medicine in Pilsen and Faculty Hospital in Pilsen, Czech Republic. jiri.kobr@lfp.cuni.cz |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Anti-Bacterial Agents / therapeutic use Chest Tubes Child Child, Preschool Combined Modality Therapy Drainage / methods Empyema, Pleural / microbiology, therapy*, ultrasonography Female Fibrinolytic Agents / administration & dosage* Follow-Up Studies Hospitalization Humans Infant Injections, Intralesional Length of Stay Logistic Models Male Multivariate Analysis Pleural Effusion / microbiology, therapy*, ultrasonography Pneumonia, Bacterial / microbiology, therapy*, ultrasonography Prospective Studies Risk Assessment Severity of Illness Index Streptokinase / administration & dosage* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Fibrinolytic Agents; EC 3.4.-/Streptokinase |
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