Alteplase in the treatment of complicated parapneumonic effusion: a case report.
نویسندگان
چکیده
The treatment of complex parapneumonic effusions in children remains controversial, with some advocating less invasive, strictly medical management and others supporting a more aggressive approach of thoracotomy with or without decortication. Recent advances, including video-assisted thoracoscopic surgery and intrapleural fibrinolytic therapy, offer new options for effective treatment. We report the first case of successful resolution of a complex parapneumonic effusion in a 16-month-old girl with the use of tissue plasminogen activator (alteplase), infused via a catheter in the pleural space.
منابع مشابه
Intrapleural hemorrhage due to alteplase use in a 6-year-old boy with pleural effusion
BACKGROUND Intrapleural fibrinolytics have been used successfully worldwide for the management of complicated pleural effusions and empyema. Bleeding complications are usually mentioned as rare side effects, but there is no clear information in the literature addressing the alarming outcome that might result following the use of alteplase as a fibrinolytic in the management of complicated parap...
متن کاملComparison of Video-Assisted Thoracoscopic Surgery and Intrapleural Urokinase as an Initial Treatment for Parapneumonic Effusion and Thoracic Empyema
Introduction: The treatment of complicated parapneumonic effusion (PPE) and thoracic empyema (TE) is controversial; and the choice of treatment after confirming the failure of simple drainage remains unclear. The purpose of this study was to compare the outcomes of intrapleural urokinase (UK) administration and video-assisted thoracoscopic surgery (VATS) as initial treatment options for PPE and...
متن کاملEffectiveness and safety of tissue plasminogen activator in the management of complicated parapneumonic effusions.
OBJECTIVE The management of parapneumonic effusions in children is controversial. The objective of this study was to evaluate the effectiveness and safety of intrapleural tissue plasminogen activator (tPA) in children who require tube thoracostomy for drainage of a complicated parapneumonic effusion. METHODS An observational cohort study was used to compare children who were treated with intr...
متن کامل[Surgical treatment of parapneumonic pleural effusion and its complications].
OBJECTIVE Surgical treatment of parapneumonic pleural effusion in children is controversial. The type of intervention is based mainly on personal experience and on the small number of reported cases. This article aims at presenting a literature review and the authorś experience in the surgical management of parapneumonic pleural effusion in children. SOURCES Data were searched in the Medline ...
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ورودعنوان ژورنال:
- Pediatrics
دوره 111 2 شماره
صفحات -
تاریخ انتشار 2003