BACKGROUND: The role of intrapleural fibrinolytic agents in the treatment of childhood empyema has not been established. A randomised double blind placebo controlled trial of intrapleural urokinase was performed in children with parapneumonic empyema. METHODS:Sixty children (median age 3.3 years) were recruited from 10 centres and randomised to receive either intrapleural urokinase 40 000 units in 40 ml or saline 12 hourly for 3 days. The primary outcome measure was length of hospital stay after entry to the trial. RESULTS: Treatment with urokinase resulted in a significantly shorter hospital stay (7.4 v 9.5 days; ratio of geometric means 1.28, CI 1.16 to 1.41 p=0.027). A post hoc analysis showed that the use of small percutaneous drains was also associated with shorter hospital stay. Children treated with a combination of urokinase and a small drain had the shortest stay (6.0 days, CI 4.6 to 7.8). CONCLUSION:Intrapleural urokinase is effective in treating empyema in children and significantly shortens hospital stay.
RCT Entities:
BACKGROUND: The role of intrapleural fibrinolytic agents in the treatment of childhood empyema has not been established. A randomised double blind placebo controlled trial of intrapleural urokinase was performed in children with parapneumonic empyema. METHODS: Sixty children (median age 3.3 years) were recruited from 10 centres and randomised to receive either intrapleural urokinase 40 000 units in 40 ml or saline 12 hourly for 3 days. The primary outcome measure was length of hospital stay after entry to the trial. RESULTS: Treatment with urokinase resulted in a significantly shorter hospital stay (7.4 v 9.5 days; ratio of geometric means 1.28, CI 1.16 to 1.41 p=0.027). A post hoc analysis showed that the use of small percutaneous drains was also associated with shorter hospital stay. Children treated with a combination of urokinase and a small drain had the shortest stay (6.0 days, CI 4.6 to 7.8). CONCLUSION: Intrapleural urokinase is effective in treating empyema in children and significantly shortens hospital stay.
Authors: I M Balfour-Lynn; E Abrahamson; G Cohen; J Hartley; S King; D Parikh; D Spencer; A H Thomson; D Urquhart Journal: Thorax Date: 2005-02 Impact factor: 9.139
Authors: Morgan K Richards; Jarod P Mcateer; Todd C Edwards; Lucas R Hoffman; Matthew P Kronman; Dennis W Shaw; Adam B Goldin Journal: Surg Infect (Larchmt) Date: 2016-11-29 Impact factor: 2.150
Authors: Galina Florova; Ali O Azghani; Sophia Karandashova; Chris Schaefer; Serge V Yarovoi; Paul J Declerck; Douglas B Cines; Steven Idell; Andrey A Komissarov Journal: Am J Physiol Lung Cell Mol Physiol Date: 2017-08-31 Impact factor: 5.464