Tratamiento de los derrames pleurales paraneumónicos

Translated title of the contribution: Management of parapneumonic pleural effusions

O. Asensio de la Cruz, J. Blanco González, A. Moreno Galdó*, J. Pérez Frías, A. Salcedo Posadas, L. Sanz Borrell, D. Álvarez Gil, V. Alzina de Aguilar, A. Andrés Martín, C. Antelo Landeira, I. Barrio Gómez de Agüero, M. Bermejo Pastor, A. Bonillo Perales, M. Bosque García, G. Cabrera Roca, M. Carrasco Zalvide, I. Cortell Aznar, J. Elorz Lambarri, A. Escribano Montaner, J. FiguerolaM. D. Frías Morales, D. Gómez-Pastrana Durán, C. Landaluce Ugarte, S. Liñán Cortés, M. Machuca Contreras, C. Martínez, C. Oliva Hernández, M. T. Pascual Sánchez, L. Pardos Rocamora, G. Pérez Pérez, E. Pérez Ruiz, C. Reverté Bover, J. Sánchez Jiménez, E. Sánchez Sánchez, A. Sequeiros González, J. Sirvent Gómez, J. M. Tabarés Lezcano, J. M. Torres Simón, M. I. Ubeda Sansano, J. R. Villa Asensi

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

17 Citations (Scopus)

Abstract

Pleural effusion in children is most often due to bacterial pneumonia. Between 0.6 and 2% of pneumonias are complicated by empyema and approximately 40% of children hospitalized with pneumonia have a pleural effusion. In recent years Streptococcus pneumoniae is the most prevalent organism. Treatment is based on the early and judicious use of antibiotics, imaging techniques, thoracocentesis, pleural drainage, fibrinolytics, thoracoscopy and thoracotomy. Indications for early pleural drainage are gross pus, positive Gram stain in pleural fluid, pleural glucose less than 50 mg/dL, pleural fluid pH of less than 7 and sonographic evidence of loculations. Local fibrinolytics may decrease the need for surgical treatment, with a success rate between 38 and 100%, according to the effusion stage. Thoracoscopic debridement is useful in the fibrinopurulent stage with loculations, with favorable results in 30-100% of patients, also depending on the effusion stage.

Translated title of the contributionManagement of parapneumonic pleural effusions
Original languageSpanish
Pages (from-to)272-282
Number of pages11
JournalAnales Espanoles de Pediatria
Volume54
Issue number3
Publication statusPublished - 2001

Keywords

  • Children
  • Empyema
  • Fibrinolytics
  • Parapneumonic pleural effusion
  • Pleural drainage
  • Pneumonia
  • Thoracoscopy

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