ULTRASONOGRAPHY GUIDED PERCUTANEOUS PLEURAL EFFUSION DRAINAGE IN NEONATES AND INFANTS: A SINGLE-CENTER EXPERIENCE

Year 2022, , 436 - 442, 31.12.2022

Çağrı Kesim , Özgür Özen

https://doi.org/10.24938/kutfd.1057049

Abstract

Objective: This study aimed to investigate the possible complications, outcomes and course of ultrasonography (USG)-guided percutaneous pleural effusion drainage (PEPED) treatment with underlying etiology of effusion in neonates and infants.
Material and Methods: In 31 patients aged 0-2 years hospitalized in the neonatal or pediatric intensive care unit, 45 catheters were inserted for USG-guided PEPED in a total of 40 sessions. Of these, a 6.3F 25 cm pigtail drainage catheter was inserted in 23 (57.5%) of our patients using the Seldinger method and in 17 (42.5%) using the trocar method. The sample fluid was biochemically classified as transudate, exudate, empyema and chylothorax. The duration of inserted catheter and type of fluid was studied along with etiological reasons for effusions.
Results: Of our 31 patients, 17 were male (54.8%) and 14 were female (45.2). The weeks of birth ranged from 25.1 to 41 weeks, with a mean of 35.55±4.22 weeks. The retention time of drainage catheters ranged from 1 to 18 days, with a mean of 6.5±4.02 days. We compared the retention time of inserted catheters between different preterm and mature groups. Besides, the various fluid characters in the postoperative patient group were compared in the context postoperative day period.
Conclusion: Catheter dwell time does not change with different levels of neonatal maturity. In neonates and infants with a history of surgery, the effusion transforms into chylothorax from hemothorax over time. Bedside USG-guided PEPED treatment for refractory pleural effusion in neonates and infants is highly safe and effective with low complication rates.

Keywords

Chylothorax, Drainage catheter, Infant, Neonate, Pleural effusion

Supporting Institution

BAŞKENT ÜNİVERSİTESİ TIP FAKÜLTESİ

Project Number

KA21/415

Thanks

Thank you for your consideration. I look forward to hearing from you.

YENİDOĞAN VE İNFANT YAŞ GRUBUNDA ULTRASONOGRAFİ KILAVUZLUĞUNDA PERKÜTAN PLEVRAL EFÜZYON DRENAJI: TEK MERKEZ DENEYİMİ

Abstract

Amaç: Plevral efüzyon infant yaş grubunda ağır bir morbidite ve mortalite sebebi olup plevral efüzyonun en sık nedeni enfeksiyöz hastalıklardır. Ancak ameliyat sonrası dönem, kardiyak ve romatolojik etkenler de persistan plevral efüzyon nedenleri olabilir. Biz bu araştırmamızda ultrasonografi kılavuzluğunda perkütan plevral efüzyon drenajı tedavisinin seyrini, olası komplikasyonlarını ve sonuçlarını etiyoloji ile bir arada değerlendirmeyi amaçladık.

Gereç ve Yöntem: 30 Nisan 2014 ile 30 Ağustos 2021 tarihleri arasında, 0-2 yaş grubunuda olup yenidoğan veya pediatrik yoğun bakımda yatan 31 hastamıza toplam 40 seansta, USG kılavuzluğunda perkütan plevral efüzyon drenajı (PEPED) amacıyla 45 kateter takıldı. Bu hastalarımızdan 23’üne Seldinger yöntemiyle (%57.5), 17’sine trokar yöntemiyle (%42.5) 6,3F 25 cm pigtail drenaj kateteri takılmış olup gelen mayi biyokimyasal olarak transüda, eksüda, ampiyem ve şilotoraks olarak sınıflandırıldı. Kateterlerin takılı olduğu süreç, kaldığı gün sayısı ve mayi karekteri, etiyolojik nedenlerle bir arada incelendi.

Bulgular: Otuz bir hastamızın 17’si erkek (%54.8), 14’ü kız (%45.2) idi. Doğum haftaları 25,1 – 41 arasında olup ortalama 35.55±4.22 idi. Takılan drenaj kateterlerinin kalış süresi 1-18 gün arasında olup ortalama 6.5±4.02 gün idi. Kateterlerin kalış süresini gruplar arasında kıyaslamak ve post-operatif hasta grubunda mayi karakteri ile post-operatif dönemde kateterin takıldığı gün arasında istatistiksel olarak anlamlı fark olup olmadığını görmek için normallik testlerini takiben Bağımsız Örneklem T-testi yapıldı.

Sonuç: İnfant yaş grubunda refrakter plevral efüzyonun tedavisinin, özellikle aspirasyon veya medikasyon ile yeterli olmadığı durumlarda, perkütan plevral efüzyon drenajı amacıyla hasta başında USG kılavuzuğunda drenaj kateteri yerleştirmek son derece güvenli bir yöntem olup komplikasyon ihtimali son derece düşük ve oldukça etkili bir yöntemdir.

Keywords

Şilotoraks, Drenaj kateteri, İnfant, Yenidoğan, Plevral efüzyon

Project Number

KA21/415

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