Stellenwert der Thoraxchirurgie im Gesamtkonzept der Behandlung von Pleuraempyemen bei Kindern

Haas, V; Bayerstorfer, R; Kuhtin, O; Bulgan, T; Hohls, M; Zap, N; Vinogradova, I. M.; Nekrasova, E. A.; Shai, Sonu; Heesen, I; Heister, P; Andrée, Colette; Niehues, Tim

doi:10.1055/s-0035-1565131

Cited by 2 publications

(2 citation statements)

References 13 publications

(20 reference statements)

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“…In our overall cohort, the median LOS was 11.8 days, the median duration of IV antibiotics was 12 days and the median duration of chest drains placement was 6 days. All these parameters are comparable with other studies in the literature 11–14…”

Section: Discussionsupporting

confidence: 90%

Management of Pediatric Thoracic Empyema in the North Queensland Region of Australia and Impact of a Local Evidence-based Treatment Guideline

Gautam

Wiseman

Legg

et al. 2021

Pediatric Infectious Disease Journal

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Aim:The North Queensland region of Australia has a high incidence of pediatric thoracic empyema (pTE). We describe the management of empyema at the Townsville University Hospital which is the regional referral center for these children. The impact of a newly developed institutional guideline is also discussed. Methods: This retrospective audit included children under the age of 16 years treated for empyema between 1 Jan 2007 and 31 December 2018. Demographic and management-related variables were correlated to outcomes. A local guideline was introduced at the beginning of 2017 and patient outcomes characteristics pre, and post introduction of this guideline are compared. Results: There were 153 children with pTE (123 before and 30 after the introduction of a local guideline). Nonsurgical management was associated with a higher treatment failure rate. Median length of stay (LOS) was 11.8 (IQR 9.3-16) days. Longer hospital LOS was associated with younger age (r 2 −0.16, P = 0.04), Aboriginal and/or Torres Strait (ATSI) ancestry (13.8 vs. 10.5 days, P = 0.002) and concomitant respiratory viral infections (14.4 vs. 10.9 days, P = 0.003). The introduction of local guideline was associated with significant decrease in the use of empirical chest CT scans (54.4% before vs. 6.7% after, P < 0.001) and duration of intravenous antibiotics (14 days before vs. 10 days after, P = 0.02). There was no significant change in the hospital LOS (12.1 days pre and 11.7 post, P = 0.8). Conclusions: Younger age, concomitant viral respiratory infections and ATSI ancestry were identified as potential risk factors for increase LOS. Hospital LOS following the adoption of an institutional guideline was unchanged. However, such a guideline may identify populations at risk for an unfavorable course and avoid unnecessary antibiotic treatment and radiation exposure.

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Section: Discussionsupporting

confidence: 90%

Management of Pediatric Thoracic Empyema in the North Queensland Region of Australia and Impact of a Local Evidence-based Treatment Guideline

Gautam

Wiseman

Legg

et al. 2021

Pediatric Infectious Disease Journal

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show abstract

“…Open chest debridement with decortication remains an option in very severe cases with excessive findings. 4,43…”

Section: Treatmentmentioning

confidence: 99%

Current Management of Pediatric Parapneumonic Pleural Effusions and Pleural Empyema

Forster,

Paul,

Liese

2023

Pediatric Infectious Disease Journal

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Stellenwert der Thoraxchirurgie im Gesamtkonzept der Behandlung von Pleuraempyemen bei Kindern

Cited by 2 publications

References 13 publications

Management of Pediatric Thoracic Empyema in the North Queensland Region of Australia and Impact of a Local Evidence-based Treatment Guideline

Management of Pediatric Thoracic Empyema in the North Queensland Region of Australia and Impact of a Local Evidence-based Treatment Guideline

Current Management of Pediatric Parapneumonic Pleural Effusions and Pleural Empyema

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