Contemporary use of fibrinolytics in the management of pediatric empyema
Topic overview
This multi-center study analyzed 581 pediatric empyema cases from 2018-2023, finding that fibrinolysis with chest drainage is now the predominant first-line treatment (67.6% of cases) and demonstrates comparable outcomes to surgical approaches with fewer complications. The research supports fibrinolysis as an effective, less invasive primary therapy option for pediatric empyema management.
Key takeaways
- Fibrinolysis with chest drainage is now the most common first-line treatment for pediatric empyema (67.6% of cases in 2018-2023).
- Length of stay did not differ significantly between fibrinolysis, chest drainage alone, or surgical approaches after adjusting for covariates.
- Only 6.9% of patients treated with fibrinolysis required subsequent VATS/decortication, demonstrating high effectiveness as primary therapy.
- VATS/open decortication had higher complication rates (11.7%) compared to chest drainage with fibrinolysis (4.1%) or drainage alone (5.8%).
- 30-day readmission rates were low and equivalent across all treatment approaches (approximately 1%), supporting fibrinolysis as safe first-line therapy.
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How to cite: GlobalCastMD. Contemporary use of fibrinolytics in the management of pediatric empyema. GlobalCastMD Medical Library. 2024-11-04. https://dev.library.globalcastmd.com/article/9389?via_space=staycurrentmd
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