Stratifying fibrinolytic dosing in pediatric parapneumonic effusion based on ultrasound grade correlation

James, Charles A.; Braswell, Leah; Pezeshkmehr, Amir; Roberson, Paula K.; Parks, James A; Moore, Mary B.

doi:10.1007/s00247-016-3711-y

Cited by 16 publications

(19 citation statements)

References 17 publications

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“…This reduces operative risk (56) and hospital stay (4), and improves prognosis (57). Deoxyribonuclease (Dnase) can reduce purulent chest fluid viscosity (58).…”

Section: Intrapleural Cavity Injectionmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication.According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future.

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“…This reduces operative risk (56) and hospital stay (4), and improves prognosis (57). Deoxyribonuclease (Dnase) can reduce purulent chest fluid viscosity (58).…”

Section: Intrapleural Cavity Injectionmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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“…It is unclear if this is due to change in antibiotic prescribing patterns, environmental exposure changes (vaping), enhanced diagnostic capabilities, or a genuine increase in incidence. Empyema is the result of pneumonia (most commonly S. pneumoniae and S. aureus ), and the common presenting symptoms include dyspnea, pleuritic chest pain, cough, fever, chills, and weight loss 7,13,14 …”

Section: Discussionmentioning

confidence: 99%

“…The American Pediatric Surgical Association treatment protocol utilizes 4 mg alteplase in 40 ml of normal saline every 24 h for 3 days with a 1‐h dwell time 16 . A weight‐based dosing of 0.1 mg/ml 17 or 1–2 mg twice daily 14 adjusts for patient and disease variability.…”

Section: Discussionmentioning

confidence: 99%

A decade's experience of pediatric lung abscess and empyema at a community hospital

Kanitra

Thampy

Cullen

2021

Pediatric Pulmonology

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Background Discussions on the diagnostic and management of acquired pediatric lung pathology are usually published by large tertiary children's hospitals. It is likely that much of this pathology is actually seen and managed in nonacademic practices. Methods A 10‐year retrospective review of patients under 18‐years of age, treated for lung abscesses or empyema was performed. Results Nineteen empyema and four lung abscesses were included. Presenting symptoms, workup, and management are reviewed. A unique subset (n = 4) of atypical pulmonary pathology is described. A 14‐year‐old with a vaping history and a lung abscess misdiagnosed as an empyema. A 15‐year‐old with primary pulmonary Hodgkin's lymphoma presenting as a lung abscess and empyema. A 5‐year‐old with an empyema complicated by a bronchopleural fistula and a 21‐year‐old with autism and an acquired lung cyst. Conclusion Our dilemmas, experiences, and strategies in managing complex lung disease are generalized to community‐based practice.

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“…Moreover, hospitalization duration is prolonged 43 . VATS efficacy decreases, particularly after 1 month, and decortication may be required in patients who underwent CDF [43][44][45][46] . In relation to this, the European Association for Cardio-Thoracic Surgery recommends that VATS should be highly considered in all advanced-stage disease patients at presentation 46 The current study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Complicated Community-Acquired Pneumonia in Children: 1-Year Data From a Tertiary Healthcare Center

Tuğcu¹,

Özsezen²,

Türkyılmaz³

et al. 2021

Preprint

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Introduction:Community-acquired pneumonia(CAP) in children has tended to decrease in recent years with effective vaccination and treatments.However,the frequency of complicated community-acquired pneumonia (CCAP) is gradually increasing.By determining risk factors for the development of CCAP,new approaches for early diagnosis and effective treatment can be determined. Method: Records of 113 patients who were hospitalized due to CAP and CCAP between January 2017 and December 2017 were examined.Demographic characteristics of the patients,comorbid diseases,admission symptoms,physical examination findings,laboratory and imaging results, treatments, hospital stay and treatment response were recorded. Pleural effusion,if empyema developed in patients with CCAP,thoracentesis and/or chest tube insertion,fibrinolytic therapy,and the need for additional surgical intervention were investigated. Results:Our patients had a mean age of 3.6 ± 2.2, 60(53%) were female and 53(47%) were male.93 (82.3%) of the patients were diagnosed with CAP and 18(15.9%) were diagnosed with CCAP.Detection of pleural effusion at the admission of patients in multivariate logistic regression[(OR (95% CI),4.24 (1.77-10.16), p <0.001)] respiratory distress(tachypnea and retraction)[(OR (95% CI) 3.04 (1.30-7.130) ),p <0.001)] and hypoxia (92% and less saO2 measured by pulse oximeter) at admission [(OR (95% CI),: 5.247 (1.58-9.46),p <0.001)] were identified as independent risk factors for diagnosis of CCAP. Discussion:Hypoxia,respiratory distress and imaging pleural effusion are important distinguishing findings for development of complications in patients admitted for CAP. Determining the etiology of CCAPs and early diagnosis and treatment approaches can be established, and protection measures can be taken. With future prospective studies, the causes of CCAP can be determined and preventive measures and new treatment approaches can be developed

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Stratifying fibrinolytic dosing in pediatric parapneumonic effusion based on ultrasound grade correlation

Cited by 16 publications

References 17 publications

Infectious pleural effusion status and treatment progress

Infectious pleural effusion status and treatment progress

A decade's experience of pediatric lung abscess and empyema at a community hospital

Risk Factors of Complicated Community-Acquired Pneumonia in Children: 1-Year Data From a Tertiary Healthcare Center

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