Urokinase instilled in the chest tube was as effective as video-assisted thoracoscopic surgery in this randomized study, but which treatment is better remains unclear.
Empyema is a common suppurative complication of bacterial pneumonia in children. Even with antibiotic treatment and chest tube placement for drainage of the purulent fluid, prolonged hospital stays, fever, anorexia, and pain are common. Recently, video-assisted thoracoscopic surgery (VATS) has been used to remove the tenacious purulent “peel” that forms as the empyema evolves. Another alternative, which does not require general anesthesia and surgery, is to instill a fibrinolytic agent that dissolves the fibrin and cellular debris to allow for better drainage. Which treatment is better?
In a randomized, multicenter clinical trial, researchers compared VATS and urokinase instillation in 103 previously healthy children <15 years of age (mean a…
Reviewing Author
DisclosuresGrant/Research SupportNIH Institutional Clinical and Translational Science Award; Agency for Healthcare Research and Quality National Center for Pediatric Practice Based Research Learning; Patient-Centered Outcomes Research Institute
Editorial BoardsCurrent Problems in Pediatric Adolescent Healthcare
Leadership Positions in Professional Societies College of Physicians of Philadelphia (Board of Trustees)
DisclosuresGrant/Research SupportNIH Institutional Clinical and Translational Science Award; Agency for Healthcare Research and Quality National Center for Pediatric Practice Based Research Learning; Patient-Centered Outcomes Research Institute
Editorial BoardsCurrent Problems in Pediatric Adolescent Healthcare
Leadership Positions in Professional Societies College of Physicians of Philadelphia (Board of Trustees)