Early Aggressive Surgical Management of Parapneumonic Empyemas

Pothula, Viswanadham; Krellenstein, Daniel J.

doi:10.1378/chest.105.3.832

Cited by 118 publications

(98 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…500'lerde açık drenajla ampiyem tedavisi uygulamıştır (2). 1876'da Hawit ampiyem kavitesine bir tüp yerleştirerek kapalı tüp drenajı metodunu tanımlamış ve ampiyem tedavisinde bir sonraki gelişmeyi gerçekleştirmiştir.…”

Section: Tari̇hçeunclassified

“…Ancak hastaların çoğunun daha önce antibiyotikle tedavi edilmiş olması nedeniyle ampiyemlerin %50-80'de etyolojik ajan belirlenebilmektedir (2,5). Torasentez parapnömonik efüzyon ve ampiyem için var olan en duyarlı ve özgül tanı yönte-midir.…”

Section: Tanıunclassified

“…Çocuklarda kullanım ilk defa 1993 de bildirilmiştir. Bu tarihten itibaren hem streptokinaz hem de ürokinazın kullanımı hakkında sunulan bildirilerde çocuklar için önerilen doz, zamanlama ve tedavi sonuçları hakkın-da çok değişik sonuçlar elde edilebilmiştir (1,2,20). Fibrinolitik tedavi daha az invaziv gibi görünmesine rağmen özellikle küçük çocuklarda travmatik ve tolere edilemeyecek yan etkilere neden olabilmektedir.…”

Section: İntraplevral Fibrinolitik Tedavi (İpf)unclassified

See 2 more Smart Citations

Pediatric Empyema, Lung Abscess, Chylothorax

Altınok¹,

Gültekin²

2012

Toraks Cer Bult

View full text Add to dashboard Cite

Section: Tari̇hçeunclassified

Section: Tanıunclassified

Section: İntraplevral Fibrinolitik Tedavi (İpf)unclassified

See 1 more Smart Citation

Pediatric Empyema, Lung Abscess, Chylothorax

Altınok¹,

Gültekin²

2012

Toraks Cer Bult

View full text Add to dashboard Cite

“…Failure of sepsis to resolve within 5-7 days is suggested as an appropriate period following which a surgical opinion should be sought. 27,28 Discussion with a thoracic surgeon should be considered in all cases failing to respond.Hypoalbuminemia, the presence of loculated fluid and anaerobic infections have been related to adverse outcome in previous studies although not in recent reports. [29][30] Long-term sequelae of pleural empyema may include residual pleural thickening (up to 13% of patients).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Outcome and mortality analysis in complicated parapneumonic effusion and empyema

Periasamy

2017

Int J Clin Trials

View full text Add to dashboard Cite

Background: Pleural infection is a clinical problem with high mortality and morbidity; 20% of patients with empyema die and approximately 20% require surgery to recover within 12 months of their infection. Studies on pleural infection and their outcome are relevant in developing a scoring system by which failing cases and cases at risk of death can be identified. Methods:The study is retrospective analysis of patient cohort admitted to the tertiary care institute from the period of July 2014 to July 2016 to determine the prognostic factors in the outcome of pleural space infection. The study included all complex, complicated parapneumonic effusion and empyema including tuberculosis above the age of fifteen years. The primary end of the present study was the success or failure. Possible predicting factors for the success or failure of therapy were assessed against this end. Pearson chi square test, χ2 (Fisher's exact test when needed) test was used for discrete data. Logistic regression analysis was applied to adjust for confounding variables to assess the possible predicting factors. Survival plot and analysis using Kaplan Meier method was used. Results: 220 with parapneumonic effusion and empyema were analyzed. Successful outcome was seen in 107 and 113 had failed outcome. Mortality was 30.50%. By logistic regression method the odds of failed outcome were high with diabetes, hypoalbuminemia, loculation, tuberculosis which can predict the outcome especially complicated and complex parapneumonic effusion, empyema (p<0.05). Conclusions: Diabetes, hypoalbuminemia, loculation, tuberculosis should be used in the prediction scoring system. Arivudainambi VP. Int J Clin Trials. 2017 Nov;4(4):176-183 International Journal of Clinical Trials | October-December 2017 | Vol 4 | Issue 4 Page 177 operative intervention. Delay in instituting proper therapy for these effusions is responsible for some of the morbidity associated with parapneumonic effusions. 5 For a simple parapneumonic effusion antibiotics according to culture and sensitivity will suffice. In complicated parapneumonic effusion and empyema intervention in the form of thoracentesis, tube thoracostomy, thoracoscopic intervention, surgery will be needed accordingly. Studies on pleural infection and their outcome are relevant in developing a scoring system by which failing cases and cases at risk of death can be identified.Empyema thoracis (ET) or pyothorax is the inflammatory process of infection in pleural space causing the accumulation and organization of purulent material in the pleural space1; first reported by Hippocrates approximately 2400 years ago.6 According to the American Thoracic Society, the ET process can be divided into three phases: (1) exudative (acute or Stage I), where exudative fluid accumulates without loculation; (2) fibrinopurulent (Stage II), where pleural fluid becomes turbid or purulent with loculation; and (3) organizing (chronic or Stage III), where thickened pus or fibrin peels begin to form, and granulation tissue replacement...

show abstract

Intra-pleural fibrinolytic therapy versus conservative management in the treatment of parapneumonic effusions and empyema

Cameron¹,

Davies²

2004

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Early Aggressive Surgical Management of Parapneumonic Empyemas

Cited by 118 publications

References 19 publications

Pediatric Empyema, Lung Abscess, Chylothorax

Pediatric Empyema, Lung Abscess, Chylothorax

Outcome and mortality analysis in complicated parapneumonic effusion and empyema

Intra-pleural fibrinolytic therapy versus conservative management in the treatment of parapneumonic effusions and empyema

Contact Info

Product

Resources

About