Source: Annual Congress 2002 - Empyema thoracis in children
Disease area: Paediatric lung diseases, Respiratory infections

Abstract

Background:The clinical evaluation and terapeutic decisions for PPE in children are still controversial. A partnership between pediatricians and surgeons arised an indicative score to chest-tube drainage. This research aims to evaluate the score usage and the PPE treatment in pediatric pacients.
Methods:This is a retrospective cross-section study with 250 pacients with PPE at the pediatric ward between 1994 at 1999. The following variables were analysed: clinical conditions, chest radiographs, pleural fluid bacteriology, pleural fluid chemistry, score and management (clinical outcome, chest-tube, thoracoscopy). The score was based in four categories: a)-appearance of the pleural liquid; b)-chest radiographies; c)-laboratory and d)-second thoracocentesis. If the score is over than 5.5, drainage would be recommended.
Results:The mean of age was 3.0 years old and median of 2.0 years old. The majority were male (146 = 58.4%). The court value obtained at R.O.C. curve to suggest pleural drainage was pH [lte]7.29, score>=5.4 and the glucose [lte]45mg%. The score value >=5.4 was 70.4% sensible and 100% specific to indicate chest drainage; the pH [lte]7.29 was 89.2% and 76.5%; the glucose [lte]45mg/dl was 68.7% and 81.7% respectively. The score was good to predict chest drainage for complicated PPE in pediatric pacients.
Conclusion:We concluded that apart of purulent aspect or positive bacterioscopy, the pH[lte]7.29, the score >=5.4 and the glucose [lte]45mg% are the best indicatives for chest drainaige. However the choose for the better method must to evaluate the viability to realization of score and the benefit to the pacients.

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Citations should be made in the following way:
G. O. Moreira, J. D. Ribeiro, A. T. Tresoldi, J. B. Silva (Campinas, Brazil). Score evaluation to management of parapneumonic effusion (PPE) in children. Eur Respir J 2002; 20: Suppl. 38, 3694

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