[Drug treatment with fibrinolytics (corrected) of secondary empyema secondary to complicated parapneumonic effusion].
In recent years we have observed in our country an increase in complications associated with bacterial pneumonia, such as pleural effusion and empyema. The initial treatment is an association of antibiotics, covering the potential germ involved, and the placement of a pleural drainage tube, in order to accelerate the resolution process. Formation of septa within the pleural cavity requires additional therapy (antifibrinolytic treatment, videothorascopy), but no one of these two alternatives is been demonstrated better than the other. We present a review that covers last 15 years (1990-2006), related to management of empyema. The management strategy with initial instillation of antifibrinolytic intrapleural makes our series the longest in our country using such treatment (30 of 50 patients reviewed (60) were treated with this technique). Initial success was 96% with this modality, without rescuing surgery. There is also a descriptive analysis of several clinical, laboratory and radiological parameters. In comparative analysis, length of stay in intensive care unit decreases in those patients treated with antifibrinolytics. This result is a prove of the efficacy of this treatment, and quite encourageing.
Diéguez
E Valdés
EV
Servicio de Cirugía Pediátrica, Hospital Universitario Infantil La Fe, Valencia. estibalizvaldes@hotmail.com
Alapont
V Modesto
VM
San Román
C Gutiérrez
CG
Micó
S Vidal
SV
Viguer
C García-Sala
CG
D000293:Adolescent; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016724:Empyema, Pleural / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000150:complications; D012189:Retrospective Studies; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator