Intrapleural fibrinolytic treatment of multiloculated pediatric empyemas

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dc.contributor.authorÜlkü, R
dc.contributor.authorÖnen, A
dc.contributor.authorOnat, S
dc.contributor.authorKilinç, N
dc.contributor.authorÖzçelik, C
dc.date.accessioned2024-04-24T16:00:10Z
dc.date.available2024-04-24T16:00:10Z
dc.date.issued2004
dc.departmentDicle Üniversitesien_US
dc.description.abstractOur objective was to compare the efficacy of adjunctive intrapleural fibrinolytic agents (IPFA) (streptokinase, urokinase) on fibrinopurulent stage empyema and chronic stage empyema in children. IPFA were used in 78 pediatric patients with empyema (36 fibrinopurulent stage empyemas, 42 chronic stage empyemas) between December 1994 and September 2002. Pleural biopsy was done for staging in all cases. Streptokinase 250,000 units in 100 ml normal saline (62 patients) or 100,000 units urokinase in 100 ml normal saline (16 patients) was instilled daily into the patient's chest tube, and the tube was clamped for 4 h, followed by suction. This treatment was continued daily for 2-8 days until resolution was demonstrated by chest radiographs and/or computed chest tomography. Success of treatment was 97.2% (complete response 24/36, partial response 11/36) in the fibrinopurulent stage and 9.4% (complete response 2/42, partial response 2/42) in chronic empyema cases. In one patient with fibrinopurulent empyema, the treatment was stopped due to allergic reaction and pleural hemorrhage; this patient died 1 day later in a septic condition. Although an invasive method, the pleural biopsy technique may be an alternative way of more properly staging thoracic empyema in selected children in whom staging based on radiographic and biochemical findings is doubtful. Intrapleural fibrinolytic treatment is an effective and safe therapy of choice and may have significant benefit in most children with fibrinopurulent phase empyema, except for those with bronchopleural fistula. IPFA do not seem to be effective in children with chronic phase empyema.en_US
dc.identifier.doi10.1007/s00383-004-1214-7
dc.identifier.endpage524en_US
dc.identifier.issn0179-0358
dc.identifier.issn1437-9813
dc.identifier.issue7en_US
dc.identifier.pmid15185109
dc.identifier.scopus2-s2.0-7644237450
dc.identifier.scopusqualityQ2
dc.identifier.startpage520en_US
dc.identifier.urihttps://doi.org/10.1007/s00383-004-1214-7
dc.identifier.urihttps://hdl.handle.net/11468/14396
dc.identifier.volume20en_US
dc.identifier.wosWOS:000223296700010
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofPediatric Surgery International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectEmpyemaen_US
dc.subjectIntrapleural Fibrinolytic Treatmenten_US
dc.subjectStreptokinaseen_US
dc.subjectUrokinaseen_US
dc.titleIntrapleural fibrinolytic treatment of multiloculated pediatric empyemasen_US
dc.titleIntrapleural fibrinolytic treatment of multiloculated pediatric empyemas
dc.typeArticleen_US

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