Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos

Background: Complicated pleural empyema has a torpid and longer clinical evolution, requiring in some patients surgical management. The predictive factors for surgical treatment are not well known. Aim: To search for clinical, laboratory or radiological predictors for the requirement of surgical tre...

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Autores principales:	Paz C,Fernando, Céspedes F,Pamela, Cuevas,Mónica, Lecorre P,Nicole, Navarro M,Héctor, García B,Cristián, Zúniga R,Sergio, Alvarez G,Cecilia, Sánchez D,Ignacio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2001
Materias:	Empyema, pleural Pleural diseases Pleural effusion
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001100008
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spelling	oai:scielo:S0034-988720010011000082002-06-12Derrame pleural y empiema complicado en niños: Evolución y factores pronósticosPaz C,FernandoCéspedes F,PamelaCuevas,MónicaLecorre P,NicoleNavarro M,HéctorGarcía B,CristiánZúniga R,SergioAlvarez G,CeciliaSánchez D,Ignacio Empyema, pleural Pleural diseases Pleural effusion Background: Complicated pleural empyema has a torpid and longer clinical evolution, requiring in some patients surgical management. The predictive factors for surgical treatment are not well known. Aim: To search for clinical, laboratory or radiological predictors for the requirement of surgical treatment in pediatric patients with empyema. Patients and methods: A retrospective review of the charts of 108 patients hospitalized for pneumonia plus pleural effusion at the Pediatric Service of the Catholic University Hospital between January 1985 and July 2000. Results: Eighty one patients had complete radiological evaluation and pleural fluid biochemical analysis. Forty nine (60%) fulfilled the criteria for empyema and 32 (40%) for an exudate. Thirteen patients with empyema required surgery and 36 were treated medically. The mean age was 3 years (range 9 months-6 years) for the surgically treated and 4 years (range 12 months-14 years) for the non-surgical group. The male/female ratio was 5:1 in the surgical group and 1:1 for the non-surgical group. Pleural fluid cultures were positive in 21 of 79 patients. Streptococcus pneumonia was the most frequently isolated agent. No significant differences were found between groups for the average days of fever prior to the diagnosis or total days of fever, days of hospital stay, pleural fluid pH (6.8 and 7.0 respectively) and glucose (21 and 31 mg/dl respectively). No differences were either observed for pleural fluid risk factors (pH < 7 and glucose <20mgdl), the presence of extensive pleural effusions, pleural loculations or bands on pleural ultrasonography and positive Gram stain or cultures in the pleural fluid. Surgical patients required oxygen for more days than medical patients (7.7 and 5.1 days; p=0.037). Conclusions: This study failed to find predictive clinical, radiological or pleural fluid parameters, for the requirement of surgical treatment of empyema (Rev Méd Chile 2001; 129: 1289-96).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.129 n.11 20012001-11-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001100008es10.4067/S0034-98872001001100008
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Empyema, pleural Pleural diseases Pleural effusion
spellingShingle	Empyema, pleural Pleural diseases Pleural effusion Paz C,Fernando Céspedes F,Pamela Cuevas,Mónica Lecorre P,Nicole Navarro M,Héctor García B,Cristián Zúniga R,Sergio Alvarez G,Cecilia Sánchez D,Ignacio Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
description	Background: Complicated pleural empyema has a torpid and longer clinical evolution, requiring in some patients surgical management. The predictive factors for surgical treatment are not well known. Aim: To search for clinical, laboratory or radiological predictors for the requirement of surgical treatment in pediatric patients with empyema. Patients and methods: A retrospective review of the charts of 108 patients hospitalized for pneumonia plus pleural effusion at the Pediatric Service of the Catholic University Hospital between January 1985 and July 2000. Results: Eighty one patients had complete radiological evaluation and pleural fluid biochemical analysis. Forty nine (60%) fulfilled the criteria for empyema and 32 (40%) for an exudate. Thirteen patients with empyema required surgery and 36 were treated medically. The mean age was 3 years (range 9 months-6 years) for the surgically treated and 4 years (range 12 months-14 years) for the non-surgical group. The male/female ratio was 5:1 in the surgical group and 1:1 for the non-surgical group. Pleural fluid cultures were positive in 21 of 79 patients. Streptococcus pneumonia was the most frequently isolated agent. No significant differences were found between groups for the average days of fever prior to the diagnosis or total days of fever, days of hospital stay, pleural fluid pH (6.8 and 7.0 respectively) and glucose (21 and 31 mg/dl respectively). No differences were either observed for pleural fluid risk factors (pH < 7 and glucose <20mgdl), the presence of extensive pleural effusions, pleural loculations or bands on pleural ultrasonography and positive Gram stain or cultures in the pleural fluid. Surgical patients required oxygen for more days than medical patients (7.7 and 5.1 days; p=0.037). Conclusions: This study failed to find predictive clinical, radiological or pleural fluid parameters, for the requirement of surgical treatment of empyema (Rev Méd Chile 2001; 129: 1289-96).
author	Paz C,Fernando Céspedes F,Pamela Cuevas,Mónica Lecorre P,Nicole Navarro M,Héctor García B,Cristián Zúniga R,Sergio Alvarez G,Cecilia Sánchez D,Ignacio
author_facet	Paz C,Fernando Céspedes F,Pamela Cuevas,Mónica Lecorre P,Nicole Navarro M,Héctor García B,Cristián Zúniga R,Sergio Alvarez G,Cecilia Sánchez D,Ignacio
author_sort	Paz C,Fernando
title	Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
title_short	Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
title_full	Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
title_fullStr	Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
title_full_unstemmed	Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos
title_sort	derrame pleural y empiema complicado en niños: evolución y factores pronósticos
publisher	Sociedad Médica de Santiago
publishDate	2001
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001100008
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Derrame pleural y empiema complicado en niños: Evolución y factores pronósticos

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