Algorithm of intervention with fibrinolytics in parapneumonic pleural effusion in pediatric patients
Keywords:
PLEURAL EFFUSION, FIBRINOLYTIC AGENTS, PEDIATRICS.Abstract
Introduction: during the last decades there has been an increase in the prevalence of septic pleural effusion as a complication of pneumonias in the pediatric age, and fibrinolytic agents are increasingly used in its treatment.
Objective: to evaluate the application of an algorithm for the management with fibrinolytics of parapneumonic pleural effusion in community-acquired pneumonias during the period from September 2019 to September 2021.
Methods: a non-observational, quasi-experimental study was carried out with a total of 36 cases with complicated pleural effusion in which a therapeutic algorithm designed for this purpose was applied. The validity of its use was obtained from the clinical history of the patients and the variables used were described statistically by means of absolute and relative frequencies. The statistical method used was the chi-square test with a significance level of α=0,05, with values of less than 0,05 being considered significant.
Results: 16 % of the cases responded to exclusive antibiotic therapy and it was shown that fibrinolytic treatment was the most effective of all the treatments used. Intrapleural septa were present in 63,9 % and 30,6 % of them disappeared with fibrinolytics. Most of the patients with biochemical characteristics of empyema required thoracotomy. The length of stay was shorter when intraspleural streptokinase was used, and there were no significant complications with any of the therapeutic options.
Conclusions: early fibrinolytic treatment avoids having to face surgical challenges in critically ill patients, achieving a low incidence of complications.
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