Intrapleural fibrinolytic treatment of multiloculated postpneumonic pediatric empyemass

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dc.contributor.authorOzcelik, C
dc.contributor.authorInci, I
dc.contributor.authorNizam, O
dc.contributor.authorOnat, S
dc.date.accessioned2024-04-24T16:18:38Z
dc.date.available2024-04-24T16:18:38Z
dc.date.issued2003
dc.departmentDicle Üniversitesien_US
dc.description.abstractBackground. Progression of empyema, with the development of fibrinous adhesions and loculations, makes simple drainage difficult or impossible. The appropriate management remains controversial. Intrapleural fibrinolytic treatment to facilitate drainage of loculated empyema instead of open thoracotomy has been advocated since the 1950s. The aim of this study was to assess the effectiveness of intrapleural fibrinolytic treatment in postpneumonic pediatric empyemas. Methods. In our clinic, we used intrapleural fibrinolytic agents in 72 pediatric patients with multiloculated empyema between 1994 and 2002. Streptokinase, 250,000 U in 100 mL of 0.9% saline solution (59 patients), and urokinase, 100,000 U in 100 mL of 0.9% saline solution (13 patients), were instilled daily into the chest tube, and the tube was clamped for 4 hours followed by suction. This treatment was continued daily for 2 to 10 days until resolution was demonstrated by chest radiograms or computed chest tomography. Results. The rate of drainage after fibrinolytic treatment was increased 73.77%. Treatment was ineffective in 14 (19.44%) of 72 patients who underwent fibrinolytic instillation. Treatment was discontinued because of allergic reaction and pleural hemorrhage in 1 patient, and because of development of bronchopleural fistula in another one. The regimen was completely successful in 43 (59.72%) patients, and partially successful in another 15 (20.83%). Twelve of those patients who had failure eventually required decortication and recovered completely. One patient died of sepsis and pleural hemorrhage; another patient died because of food aspiration. Conclusions. In all patients with loculations except those with a bronchopleural fistula, intrapleural fibrinolytic treatment should be tried. Thus, the majority of children with loculated empyemas can be treated successfully without invasive interventions, such as thoracoscopic debridements or open surgery. (Ann Thorac Surg 2003;76:1849-53) (C) 2003 by The Society of Thoracic Surgeons.en_US
dc.identifier.doi10.1016/S0003-4975(03)01012-9
dc.identifier.endpage1853en_US
dc.identifier.issn0003-4975
dc.identifier.issue6en_US
dc.identifier.pmid14667597
dc.identifier.scopus2-s2.0-0345527943
dc.identifier.scopusqualityQ1
dc.identifier.startpage1849en_US
dc.identifier.urihttps://doi.org/10.1016/S0003-4975(03)01012-9
dc.identifier.urihttps://hdl.handle.net/11468/16210
dc.identifier.volume76en_US
dc.identifier.wosWOS:000186986500015
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofAnnals of Thoracic Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subject[No Keyword]en_US
dc.titleIntrapleural fibrinolytic treatment of multiloculated postpneumonic pediatric empyemassen_US
dc.titleIntrapleural fibrinolytic treatment of multiloculated postpneumonic pediatric empyemass
dc.typeArticleen_US

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