Derrame pleural parapneumônico e empiema

Marchi, Evaldo; Lundgren, Fernando Luiz Cavalcanti; Mussi, Ricardo Kalaf

doi:10.1590/s1806-37132006000900005

Cited by 7 publications

(10 citation statements)

References 25 publications

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“…The management of patients with suspected pleural infection or disease at our institution was performed in accordance with the Brazilian Guidelines for Pleural Empyema Management (16), which are similar to the British Thoracic Society guidelines for the management of pleural infection (17). Briefly, patients with a pleural effusion demonstrating purulent fluid or aglucose level <40 mg/dL, lactate dehydrogenase level>1,000 IU/L, or positive Gram stain or culture were selected to undergo thoracostomy tube drainage and an intravenous antibiotics regimen.…”

Section: Methodsmentioning

confidence: 99%

Does videothoracoscopy improve clinical outcomes when implemented as part of a pleural empyema treatment algorithm?

Terra¹,

Waisberg²,

Almeida³

et al. 2012

Clinics

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OBJECTIVE:We aimed to evaluate whether the inclusion of videothoracoscopy in a pleural empyema treatment algorithm would change the clinical outcome of such patients.METHODS:This study performed quality-improvement research. We conducted a retrospective review of patients who underwent pleural decortication for pleural empyema at our institution from 2002 to 2008. With the old algorithm (January 2002 to September 2005), open decortication was the procedure of choice, and videothoracoscopy was only performed in certain sporadic mid-stage cases. With the new algorithm (October 2005 to December 2008), videothoracoscopy became the first-line treatment option, whereas open decortication was only performed in patients with a thick pleural peel (>2 cm) observed by chest scan. The patients were divided into an old algorithm (n = 93) and new algorithm (n = 113) group and compared. The main outcome variables assessed included treatment failure (pleural space reintervention or death up to 60 days after medical discharge) and the occurrence of complications.RESULTS:Videothoracoscopy and open decortication were performed in 13 and 80 patients from the old algorithm group and in 81 and 32 patients from the new algorithm group, respectively (p<0.01). The patients in the new algorithm group were older (41±1 vs. 46.3±16.7 years, p = 0.014) and had higher Charlson Comorbidity Index scores [0(0-3) vs. 2(0-4), p = 0.032]. The occurrence of treatment failure was similar in both groups (19.35% vs. 24.77%, p = 0.35), although the complication rate was lower in the new algorithm group (48.3% vs. 33.6%, p = 0.04).CONCLUSIONS:The wider use of videothoracoscopy in pleural empyema treatment was associated with fewer complications and unaltered rates of mortality and reoperation even though more severely ill patients were subjected to videothoracoscopic surgery.

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Section: Methodsmentioning

confidence: 99%

Does videothoracoscopy improve clinical outcomes when implemented as part of a pleural empyema treatment algorithm?

Terra¹,

Waisberg²,

Almeida³

et al. 2012

Clinics

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“…No empiema crônico neutrofílico de difícil resolução, devemos considerar a etiologia anaeróbica, sendo imperativo avaliar culturas anaeróbicas do líquido. (13)(14) É fato também que pacientes portadores de derrame pleural neutrofílico crônico podem ocasionalmente ser portadores de actinomicose ou nocardiose, sendo que culturas para estes agentes devem ser realizadas em casos suspeitos. (2)…”

Section: Derrame Parapneumônico E Empiemaunclassified

Derrame pleural de origem indeterminada

Genofre

Chibante²,

Macedo

2006

J. bras. pneumol.

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“…About 50% to 70% of pleural effusions in children are caused by infections secondary to pneumonia, which are discovered due to a chest X-ray for initial diagnosis and reversed with the same antibiotic treatment for community-acquired pneumonia. However, when there is no response to treatment, pleural effusion may have increased its volume and evolve into the so-called complicated pleural effusions and atelectasis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Thoracic Block Technique Associated with Positive End-Expiratory Pressure in Reversing Atelectasis

Pereira

Netto

Silva

et al. 2015

Case Reports in Pediatrics

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A preschool four-year-old male patient had been admitted to the Mandaqui Hospital with a diagnosis of lobar pneumonia, pleural effusion, and right lung atelectasis. Treatment consisted of antibiotics and physiotherapy sessions, using a technique described in the literature as Insufflation Technique to Reverse Atelectasis (ITRA), which consists of a thoracic block of healthy lung tissue, leaving only the atelectasis area free, associated with the use of invasive or noninvasive mechanical ventilation with positive airway pressure for reversal of atelectasis. Two physiotherapy sessions were conducted daily. The sessions lasted 20 minutes and were fractionated into four series of five minutes each. Each series bilateral thoracic block was performed for 20 seconds with a pause lasting for the same time. Associated with the thoracic block, a continuous positive airways pressure was used using a facial mask and 7 cm H2O PEEP provided via CPAP. Conclusion. ITRA technique was effective in reversing atelectasis in this patient.

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Derrame pleural parapneumônico e empiema

Cited by 7 publications

References 25 publications

Does videothoracoscopy improve clinical outcomes when implemented as part of a pleural empyema treatment algorithm?

Does videothoracoscopy improve clinical outcomes when implemented as part of a pleural empyema treatment algorithm?

Derrame pleural de origem indeterminada

Thoracic Block Technique Associated with Positive End-Expiratory Pressure in Reversing Atelectasis

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