Treatment of Complicated Parapneumonic Pleural Effusion with Intrapleural Streptokinase in Children

Chih Ta Yao, Jing Ming Wu, Ching Chuan Liu, Ming Ho Wu, Hung Yi Chuang, Jieh Neng Wang

研究成果: Article

57 引文 (Scopus)

摘要

Objective: To evaluate the role of intrapleural streptokinase in the management of complicated parapneumonic effusions in children. Design: Prospective comparative study. Setting: Cheng Kung University Hospital, a tertiary medical center in Tainan, Taiwan. Patients and methods: We enrolled as our prospective study group 20 consecutive children with complicated parapneumonic effusions who received intrapleural streptokinase treatment between August 2000 and July 2002. We also retrospectively analyzed a comparison group of 22 consecutive children with complicated parapneumonic effusions who received chest tube drainage without streptokinase treatment from January 1992 to July 2000. We then compared the clinical manifestations and outcome of these two patient groups. The patient population (21 boys and 21 girls) ranged in age from 9 to 130 months (mean age, 41.5 ± 26.3 months [mean ± SD]). The characters of pleural effusion showed no difference between the two groups. Nineteen patients had positive findings for Streptococcus pneumoniae, 2 patients had positive findings for Staphylococcus aureus, 2 patients had positive findings for Pseudomonas aeruginosa, and 19 patients had undetermined pathogens. All patients were treated with appropriate antibiotics. Results: More pleural fluid was drained from the streptokinase group than from the comparison group during streptokinase treatment (816 ± 481 mL vs 279 ± 238 mL, p < 0.01). The duration of fever after chest tube insertion was also significantly lower in the study group (5.3 ± 3.1 days vs 7.9 ± 4.6 days, p < 0.05). Only two patients in the streptokinase group required surgical intervention compared with nine patients in the comparison group (p < 0.05). No major side effects were noticed after streptokinase instillation. Conclusion: Intrapleural fibrinolytic treatment with streptokinase is safe and effective, and it can obviate the need for surgery in most cases. The combination treatment should be attempted early on, when complicated parapneumonic effusion is first diagnosed.

原文English
頁(從 - 到)566-571
頁數6
期刊Chest
125
發行號2
DOIs
出版狀態Published - 2004 二月

指紋

Streptokinase
Pleural Effusion
Therapeutics
Chest Tubes
Prospective Studies
Streptococcus pneumoniae
Taiwan
Pseudomonas aeruginosa
Staphylococcus aureus
Drainage
Fever
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

引用此文

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title = "Treatment of Complicated Parapneumonic Pleural Effusion with Intrapleural Streptokinase in Children",
abstract = "Objective: To evaluate the role of intrapleural streptokinase in the management of complicated parapneumonic effusions in children. Design: Prospective comparative study. Setting: Cheng Kung University Hospital, a tertiary medical center in Tainan, Taiwan. Patients and methods: We enrolled as our prospective study group 20 consecutive children with complicated parapneumonic effusions who received intrapleural streptokinase treatment between August 2000 and July 2002. We also retrospectively analyzed a comparison group of 22 consecutive children with complicated parapneumonic effusions who received chest tube drainage without streptokinase treatment from January 1992 to July 2000. We then compared the clinical manifestations and outcome of these two patient groups. The patient population (21 boys and 21 girls) ranged in age from 9 to 130 months (mean age, 41.5 ± 26.3 months [mean ± SD]). The characters of pleural effusion showed no difference between the two groups. Nineteen patients had positive findings for Streptococcus pneumoniae, 2 patients had positive findings for Staphylococcus aureus, 2 patients had positive findings for Pseudomonas aeruginosa, and 19 patients had undetermined pathogens. All patients were treated with appropriate antibiotics. Results: More pleural fluid was drained from the streptokinase group than from the comparison group during streptokinase treatment (816 ± 481 mL vs 279 ± 238 mL, p < 0.01). The duration of fever after chest tube insertion was also significantly lower in the study group (5.3 ± 3.1 days vs 7.9 ± 4.6 days, p < 0.05). Only two patients in the streptokinase group required surgical intervention compared with nine patients in the comparison group (p < 0.05). No major side effects were noticed after streptokinase instillation. Conclusion: Intrapleural fibrinolytic treatment with streptokinase is safe and effective, and it can obviate the need for surgery in most cases. The combination treatment should be attempted early on, when complicated parapneumonic effusion is first diagnosed.",
author = "Yao, {Chih Ta} and Wu, {Jing Ming} and Liu, {Ching Chuan} and Wu, {Ming Ho} and Chuang, {Hung Yi} and Wang, {Jieh Neng}",
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Treatment of Complicated Parapneumonic Pleural Effusion with Intrapleural Streptokinase in Children. / Yao, Chih Ta; Wu, Jing Ming; Liu, Ching Chuan; Wu, Ming Ho; Chuang, Hung Yi; Wang, Jieh Neng.

於: Chest, 卷 125, 編號 2, 02.2004, p. 566-571.

研究成果: Article

TY - JOUR

T1 - Treatment of Complicated Parapneumonic Pleural Effusion with Intrapleural Streptokinase in Children

AU - Yao, Chih Ta

AU - Wu, Jing Ming

AU - Liu, Ching Chuan

AU - Wu, Ming Ho

AU - Chuang, Hung Yi

AU - Wang, Jieh Neng

PY - 2004/2

Y1 - 2004/2

N2 - Objective: To evaluate the role of intrapleural streptokinase in the management of complicated parapneumonic effusions in children. Design: Prospective comparative study. Setting: Cheng Kung University Hospital, a tertiary medical center in Tainan, Taiwan. Patients and methods: We enrolled as our prospective study group 20 consecutive children with complicated parapneumonic effusions who received intrapleural streptokinase treatment between August 2000 and July 2002. We also retrospectively analyzed a comparison group of 22 consecutive children with complicated parapneumonic effusions who received chest tube drainage without streptokinase treatment from January 1992 to July 2000. We then compared the clinical manifestations and outcome of these two patient groups. The patient population (21 boys and 21 girls) ranged in age from 9 to 130 months (mean age, 41.5 ± 26.3 months [mean ± SD]). The characters of pleural effusion showed no difference between the two groups. Nineteen patients had positive findings for Streptococcus pneumoniae, 2 patients had positive findings for Staphylococcus aureus, 2 patients had positive findings for Pseudomonas aeruginosa, and 19 patients had undetermined pathogens. All patients were treated with appropriate antibiotics. Results: More pleural fluid was drained from the streptokinase group than from the comparison group during streptokinase treatment (816 ± 481 mL vs 279 ± 238 mL, p < 0.01). The duration of fever after chest tube insertion was also significantly lower in the study group (5.3 ± 3.1 days vs 7.9 ± 4.6 days, p < 0.05). Only two patients in the streptokinase group required surgical intervention compared with nine patients in the comparison group (p < 0.05). No major side effects were noticed after streptokinase instillation. Conclusion: Intrapleural fibrinolytic treatment with streptokinase is safe and effective, and it can obviate the need for surgery in most cases. The combination treatment should be attempted early on, when complicated parapneumonic effusion is first diagnosed.

AB - Objective: To evaluate the role of intrapleural streptokinase in the management of complicated parapneumonic effusions in children. Design: Prospective comparative study. Setting: Cheng Kung University Hospital, a tertiary medical center in Tainan, Taiwan. Patients and methods: We enrolled as our prospective study group 20 consecutive children with complicated parapneumonic effusions who received intrapleural streptokinase treatment between August 2000 and July 2002. We also retrospectively analyzed a comparison group of 22 consecutive children with complicated parapneumonic effusions who received chest tube drainage without streptokinase treatment from January 1992 to July 2000. We then compared the clinical manifestations and outcome of these two patient groups. The patient population (21 boys and 21 girls) ranged in age from 9 to 130 months (mean age, 41.5 ± 26.3 months [mean ± SD]). The characters of pleural effusion showed no difference between the two groups. Nineteen patients had positive findings for Streptococcus pneumoniae, 2 patients had positive findings for Staphylococcus aureus, 2 patients had positive findings for Pseudomonas aeruginosa, and 19 patients had undetermined pathogens. All patients were treated with appropriate antibiotics. Results: More pleural fluid was drained from the streptokinase group than from the comparison group during streptokinase treatment (816 ± 481 mL vs 279 ± 238 mL, p < 0.01). The duration of fever after chest tube insertion was also significantly lower in the study group (5.3 ± 3.1 days vs 7.9 ± 4.6 days, p < 0.05). Only two patients in the streptokinase group required surgical intervention compared with nine patients in the comparison group (p < 0.05). No major side effects were noticed after streptokinase instillation. Conclusion: Intrapleural fibrinolytic treatment with streptokinase is safe and effective, and it can obviate the need for surgery in most cases. The combination treatment should be attempted early on, when complicated parapneumonic effusion is first diagnosed.

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