2013, Number 3
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AMC 2013; 17 (3)
Diagnostic and therapeutic alternatives in children with complicated parapneumonic pleural effusion
Castelló GM, Hernández ME, Delgado MN, Bueno RJC
Language: Spanish
References: 41
Page: 324-335
PDF size: 84.30 Kb.
ABSTRACT
Background: pleural effusion is one of the complications of pneumonia in children. Although antimicrobial treatment and general measures are sufficient in some patients, others require methods for the drainage of the pleural content that have advantages and disadvantages.
Objective: to discuss the different diagnostic and therapeutic alternatives for complicated parapneumonic pleural effusion in pediatric patients, making emphasis in current tendencies and opinions in this field, particularly from the perspective of pediatric surgeons.
Methods: a bibliographic research was carried out in Scopus database through Hinari, and also in Medline/Medline Plus through PubMed, using
empyema, thoracoscopy, fibrinolytics and children as descriptors.
Conclusions: high survival rates and less frequency of severe complications in children with parapneumonic pleural effusion have resulted from the implementation of effective and early procedures. The use of fibrinolytic agents or videothorascopy, seem to favor not significantly any of the two procedures. The use of fibrinolytic agents or VATS has not shown remarkable differences in terms of final results, but both methods have proved to be effective.
REFERENCES
Thomson A, Harris M. Community-acquired pneumonia in children: what's new? Thorax. 2011 Oct;66(10):927-8.
López Antuñano FJ. Epidemiología de las Infecciones Respiratorias Agudas en niños: panorama regional. En: Benguigui Y, López Antuñano FJ, Schmunis G, Yunes J, editores. Infecciones respiratorias en niños. Washington: Organización Paramericana de la Salud; 1999. p. 3-23.
Walker W, Wheeler R, Legg J. Update on the causes, investigation and management of empyema in childhood. Arch Dis Child. 2011 May;96(5):482-8.
Yousef AA, Jaffé A. The management of paediatric empyema. Hong Kong J Paediatr. 2009;14(1):16-21.
Carter E, Waldhausen J, Zhang W, Hoffman L, Redding G. Management of children with empyema: Pleural drainage is not always necessary. Pediatric Pulmonol. 2010 May;45(5):475-80.
Irving K, Snowden C, Blackburn S, Alexander E, Hallows R, Chetty K, et al. Management of empyema in children: a clinical audit. Arch Dis Child. 2012 May;97(suppl 1):A14-A5.
Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society Guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66:ii1-ii23.
Paraskakis E, Vergadi E, Chatzimichael A, Bouros D. Current evidence for the management of paediatric parapneumonic effusions. Curr Med Reserch Opin. 2012 Jul;28(7):1179-92.
PM, Foglia RP, Skinner MA, editores. Surgery of Infants and Children: Scientific Principles and Practice. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 929-49.
Light R. Parapneumonic effusions and empyema. En: Light R, editor. Pleural diseases. 3ra ed. Baltimore: Lippincot Williams and Wilkins; 1995. p. 129-53.
Proesmans M, De Boeck K. Clinical practice: Treatment of childhood empyema. Eur J Pediatr. 2009 Jun;168(6):639-45.
Westra SJ, Choy G. What imaging should we perform for the diagnosis and management of pulmonary infections? Pediatr Radiol. 2009 Apr;39(Suppl. 2):S178-S83.
Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 2009 Jun;39(6):527-37.
Hilliard T, Henderson A, Langton Hewer S. Management of parapneumonic effusion and empyema. Arch Dis Child. 2003 Oct;88(10):915-7.
Balfour-Lynn IM, Abrahamson E, Cohen G, Hartley J, King S, Parikh D, et al. British Thoracic Society guidelines for the management of pleural infection in children. Thorax. 2005 Feb;60(Suppl 1):i1-i21.
Chan P, Crawford O, Wallis C. Treatment of pleural empyema. J Paediatr Child Health. 2000 Aug;36(4):375-7.
Meier A, Smith B, Raghavan A. Rational treatment of empyema in children. Arch Surg. 2000 Aug;135(8):907-12.
Kurian J, Levin TL, Han BK, Taragin BH, Weinstein S. Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. Am J Roentgenol. 2009 Dec;193(6):1648-54.
Jaffe A, Calder A, Owens CM, Stanojevic S, Sonnappa S. Role of routine computed tomography in paediatric pleural empyema. Thorax. 2008 May;63(10):897-902.
Marhuenda C, Barceló C, Molino JA, Guillén G, Moreno A, Martínez X. Tratamiento del empiema paraneumónico tabicado: ¿videotoracoscopia o fibrinolíticos? An Pediatr. 2011 Nov;75(5):307-13.
Molina Vázquez ME, Lema A, Palacios M, Somoza I, Tellado MG, Vela D. Toracoscopia en niños con empiema pleural en fase II. ¿Lavado y desbridamiento de tabiques de fibrina o decorticación? Acta Pediatr Esp. 2010 May;68(5):241-4.
Coote N, Kay ES. WITHDRAWN: Surgical versus non-surgical management of pleural empyema. Cochrane database Syst Rev. 2009 Oct 7;(4):CD001956.
Kerek O, Hilliard T, Henderson J. What is the best treatment for empyema? Arch Dis Child. 2008 Feb;93(2):173-4.
Wong K, Lin T, Huang Y, Chang L, Lai S. Scoring system for empyema thoracis and help in management. Indian J Pediatr. 2005 Dec;72(12):1025-8.
Rothenberg SS. The role of thoracoscopic decortication in the treatment of childhood empyema. Pediatr Allerg Immunol Pulmonol. 2012 Aug;25(3):155-8.
Velaiutham S, Pathmanathan S, Whitehead B, Kumar R. Video-assisted thoracoscopic surgery of childhood empyema: early referral improves outcome. Pediatr Surg Int. 2010 Oct;26(10):1031-5.
Freitas S, Fraga J, Canani F. Toracoscopia em crianças com derrame pleural parapneumônico complicado na fase fibrinopurulenta: Estudo multi-institucional. J Bras Pneumol. 2009 Jul;35(7):660-8.
Oak SN, Parelkar SV, Satishkumar KV, Pathak R, Ramesh BH, Sudhir S, et al. Review of video-assisted thoracoscopy in children. J Minim Access Surg. 2009 Jul-Sept;5(3):57-62.
Rothenberg SS. Thoracoscopy in infants and children: the state of the art. J Pediatr Surg. 2005 Feb;40(2):303-6.
Rodgers B, Talbert J. Thoracoscopy for diagnosis of intrathoracic lesions in children. J Pediatr Surg. 1976 Oct;11(5):703-8.
Pappalardo E, Laungani A, Demarche M, Erpicum P. Early thoracoscopy for the management of empyema in children. Acta Chir Belg. 2009 Oct;109(5):602-5.
Grewal H, Jackson RJ, Wagner CW, Smith SD. Early video-assisted thoracic surgery in the management of empyema. Pediatrics. 1999 May;103(5):63-7.
Goldin AB, Parimi C, LaRiviere C, Garrison M, Larison CL, Sawin RS. Outcomes associated with type of intervention and timing in complex pediatric empyema. Am J Surg. 2012 May;203(5):665-73.
Tobias JD. Thoracoscopy in the pediatric patient. Anesth Clin North Am. 2001 Mar;19(1):182-91.
McGahren E, Kern J, Rodgers B. Anesthetic techniques for pediatric thoracoscopy. Ann Thorac Surg. 1995 Oct;60(4):927-30.
Stefanutti G, Ghirardo V, Barbato A, Gamba P. Evaluation of a pediatric protocol of intrapleural urokinase for pleural empyema: a prospective study. Surgery. 2010 Sept;148(3):589-94.
Khalil BA, Corbett PA, Jones MO, Baillie CT, Southern K, Losty PD, et al. Less is best? The impact of urokinase as the first line management of empyema thoracis. Pediatr Surg Int. 2007 Feb;23(2):129-33.
Ekingen G, Guvenc B, Sozubir S, Tuzlaci A, Senel U. Fibrinolytic treatment of complicated pediatric thoracic empyemas with intrapleural streptokinase. Eur J Cardiothorac Surg. 2004 Sept;26(3):503-7.
Thomas MF, Simmister C, Cliff D, Elemraid MA, Clark JE, Rushton SP, et al. Comparison of primary pleural drainage strategies in paediatric empyema. Thorax. 2011 Dec;66(Suppl 4):A137-A8.
Sonnappa S, Cohen G, Owens CM, van Doorn C, Cairns J, Stanojevic S, et al. Comparison of urokinase and video-assisted thoracoscopic surgery for treatment of childhood empyema. Am J Respir Crit Care Med. 2006 Jul;174(2):221-7.
Jaffé A, Balfour-Lynn IM. Management of empyema in children. Pediatr Pulmonol. 2005 Aug;40(2):148-56.