Source: Annual Congress 2002 - Empyema thoracis in children
Disease area: Thoracic oncology

Abstract

Objective. To assess and contrast the outcomes of image-guided therapeutic needle aspiration with image-guided percutaneous catheter drainage in the management of parapneumonic effusions in children.
Materials and Methods. The medical records, microbiology and radiology reports of 67 children who presented with parapneumonic effusions and underwent primary image-guided drainage between April 1, 1995 and April 1, 2000 were retrospectively reviewed.
Results. The two drainage methods had similar median length of stay and complication rates. The reintervention rate in this study was 27% (18 patients). Children who underwent primary aspiration had significantly higher rates of reintervention. Loculation of the fluid collection (P = .03), the method of drainage (P < .001), and the pH level (P < .001) of the aspirated fluid were independent predictors of reintervention.
Conclusions. Aspiration and catheter drainage had similar complication rates and lengths of stay, but children who underwent primary aspiration had significantly higher reintervention rates, particularly when the pH of the aspirated fluid was below 7.2. Therefore, primary catheter placement should be considered in children who undergo diagnostic paracentesis for parapneumonic effusions. Such a consideration could be facilitated by the availability of a pH meter.

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Citations should be made in the following way:
R. K. Mitri, S. D. Brown, D. Zurakowski, K. Y. Chung, O. Konez, P. E. Burrows, A. A. Colin (Boston). Outcomes of primary image-guided drainage of parapneumonic effusions in children. Eur Respir J 2002; 20: Suppl. 38, 3693

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