Year 2019, Volume , Issue , Pages 1 - 8 2019-08-06

Pleural empyema and fibrinolytic therapy in children: A single center experience
Çocuklarda plevral ampiyem ve fibrinolitik tedavi: Tek merkez deneyimi

Saliha KANIK YÜKSEK [1] , Belgin Gülhan [2] , Aslınur Özkaya Parlakay [3] , Hasan Tezer [4] , Gülşah Bayram Ilıkan [5] , Güzin Cinel [6] , Can İhsan Öztorun [7] , Süleyman Arif Bostancı [8] , Vildan Selin Şahin [9] , Emrah Şenel [10]


Objective: Pleural empyema (PE) is a serious complication of pneumonia and continues to be an important problem. Different treatment approaches are remarkable in many reports, but do not provide strong evidence for ideal treatment. In this study, we aimed to evaluate our approach to the patients diagnosed as PE, and to demonstrate the experience of our center in the shadow of the not fully seated treatment approach in previously published studies.

Material and Methods: This is a retrospective study of 48 patients aged between 1-17 years from January 2011 to December 2016 in one center. Pre-admission status, risks and treatments of the patients, clinical and laboratory findings on admission, selected treatment approaches, especially the fibrinolytic therapy, and complications were evaluated.

Results: Tube thoracostomy was performed in 43/48 (89.6%). Patients treated with fibrinolytic therapy was 22 (45.8%) and the mean dose was 5,18±2,59 (1-9) in total. Fibrinolytic therapy was significantly higher in PE stage (II) than the other stages (p = 0.001). Intensive care need was 20.8% (n = 10) while total hospital stay was 23.58 ± 8.69 (3-47) days.  Thoracotomy/decortication or VATS were required in five (10.4%) patients. There was no significant relationship between the operation and fibrinolytic treatment status of patients. The complication rate was 41.6% in total.

Conclussion: The therapeutic approach to PE in children is not standardized. As a result, each center seems to prefer to apply its own treatment approach, considering previous experiences and results, like in our center.

Amaç: Plevral ampiyem (PA) pnömoninin ciddi bir komplikasyonudur ve önemli bir problem olmaya devam etmektedir. Farklı tedavi yaklaşımları yayımlanmış birçok raporda dikkat çekicidir, ancak ideal tedavi için güçlü kanıt sağlamamaktadır. Bu çalışmada, PA tanısı alan hastalara yaklaşımımızı değerlendirmeyi ve daha önce yayınlanmış çalışmalarda tam oturmamış tedavi yaklaşımı gölgesinde merkezimizin deneyimini sunmayı amaçladık.

Gereç ve Yöntemler: Bu çalışma Ocak 2011-Aralık 2016 tarihleri arasında tek merkezde izlenen 1-17 yaşları arasındaki 48 hastanın değerlendirildiği retrospektif bir çalışmadır. Hastaların başvuru öncesi durumları,  riskleri ve tedavileri, başvuru sırasındaki klinik ve laboratuvar bulguları, seçilmiş tedavi yaklaşımları, özellikle fibrinolitik tedavi ve komplikasyonlar değerlendirilmiştir.

Bulgular: Tüp torakostomi 43/48 (% 89,6) hastaya uygulandı. Fibrinolitik tedavi ile tedavi edilen hastaların sayısı 22 (% 45.8) ve ortalama doz toplamda 5,18 ± 2,59 (1-9) idi. Fibrinolitik tedavi PA evre II'de diğer evrelere göre anlamlı derecede yüksekti (p = 0.001). Yoğun bakım ihtiyacı % 20,8 (n = 10) iken toplam hastanede kalış süresi 23,58 ± 8,69 (3-47) gündü. Beş hastada (% 10.4) cerrahi girişim gerekli oldu. Ameliyat ile hastaların fibrinolitik tedavi durumu arasında anlamlı ilişki bulunmadı. Komplikasyon oranı toplamda % 41.6 idi.

Sonuç: Çocuklarda PA'da tedavi yaklaşımı standardize edilmemiştir. Sonuç olarak, her merkez bizim merkezimizde olduğu gibi önceki deneyimleri ve sonuçları göz önünde bulundurarak kendi tedavi yaklaşımını uygulamayı tercih ediyor gibi görünmektedir.

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Primary Language en
Subjects General and Internal Medicine
Journal Section ORIGINAL ARTICLES
Authors

Orcid: 0000-0002-2538-2872
Author: Saliha KANIK YÜKSEK (Primary Author)
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0003-0839-1301
Author: Belgin Gülhan
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0001-5691-2461
Author: Aslınur Özkaya Parlakay
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0001-6871-4112
Author: Hasan Tezer
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0001-5833-022X
Author: Gülşah Bayram Ilıkan
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0002-6209-196X
Author: Güzin Cinel
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0002-5408-2772
Author: Can İhsan Öztorun
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0002-7512-3895
Author: Süleyman Arif Bostancı
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0002-6043-5642
Author: Vildan Selin Şahin
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Orcid: 0000-0002-0383-4559
Author: Emrah Şenel
Institution: SBÜ Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH
Country: Turkey


Dates

Publication Date : August 6, 2019

Bibtex @research article { tchd523491, journal = {Türkiye Çocuk Hastalıkları Dergisi}, issn = {1307-4490}, eissn = {2148-3566}, address = {Şehit Ömer Halisdemir Cad. Kurtdereli Sok. No:10 ANKARA}, publisher = {Sağlık Bilimleri Üniversitesi}, year = {2019}, volume = {}, pages = {1 - 8}, doi = {10.12956/tchd.523491}, title = {Pleural empyema and fibrinolytic therapy in children: A single center experience}, key = {cite}, author = {KANIK YÜKSEK, Saliha and Gülhan, Belgin and Özkaya Parlakay, Aslınur and Tezer, Hasan and Bayram Ilıkan, Gülşah and Cinel, Güzin and Öztorun, Can İhsan and Bostancı, Süleyman Arif and Şahin, Vildan Selin and Şenel, Emrah} }
APA KANIK YÜKSEK, S , Gülhan, B , Özkaya Parlakay, A , Tezer, H , Bayram Ilıkan, G , Cinel, G , Öztorun, C , Bostancı, S , Şahin, V , Şenel, E . (2019). Pleural empyema and fibrinolytic therapy in children: A single center experience. Türkiye Çocuk Hastalıkları Dergisi , () , 1-8 . DOI: 10.12956/tchd.523491
MLA KANIK YÜKSEK, S , Gülhan, B , Özkaya Parlakay, A , Tezer, H , Bayram Ilıkan, G , Cinel, G , Öztorun, C , Bostancı, S , Şahin, V , Şenel, E . "Pleural empyema and fibrinolytic therapy in children: A single center experience". Türkiye Çocuk Hastalıkları Dergisi (2019 ): 1-8 <https://dergipark.org.tr/en/pub/tchd/issue/43771/523491>
Chicago KANIK YÜKSEK, S , Gülhan, B , Özkaya Parlakay, A , Tezer, H , Bayram Ilıkan, G , Cinel, G , Öztorun, C , Bostancı, S , Şahin, V , Şenel, E . "Pleural empyema and fibrinolytic therapy in children: A single center experience". Türkiye Çocuk Hastalıkları Dergisi (2019 ): 1-8
RIS TY - JOUR T1 - Pleural empyema and fibrinolytic therapy in children: A single center experience AU - Saliha KANIK YÜKSEK , Belgin Gülhan , Aslınur Özkaya Parlakay , Hasan Tezer , Gülşah Bayram Ilıkan , Güzin Cinel , Can İhsan Öztorun , Süleyman Arif Bostancı , Vildan Selin Şahin , Emrah Şenel Y1 - 2019 PY - 2019 N1 - doi: 10.12956/tchd.523491 DO - 10.12956/tchd.523491 T2 - Türkiye Çocuk Hastalıkları Dergisi JF - Journal JO - JOR SP - 1 EP - 8 VL - IS - SN - 1307-4490-2148-3566 M3 - doi: 10.12956/tchd.523491 UR - https://doi.org/10.12956/tchd.523491 Y2 - 2019 ER -
EndNote %0 Türkiye Çocuk Hastalıkları Dergisi Pleural empyema and fibrinolytic therapy in children: A single center experience %A Saliha KANIK YÜKSEK , Belgin Gülhan , Aslınur Özkaya Parlakay , Hasan Tezer , Gülşah Bayram Ilıkan , Güzin Cinel , Can İhsan Öztorun , Süleyman Arif Bostancı , Vildan Selin Şahin , Emrah Şenel %T Pleural empyema and fibrinolytic therapy in children: A single center experience %D 2019 %J Türkiye Çocuk Hastalıkları Dergisi %P 1307-4490-2148-3566 %V %N %R doi: 10.12956/tchd.523491 %U 10.12956/tchd.523491
ISNAD KANIK YÜKSEK, Saliha , Gülhan, Belgin , Özkaya Parlakay, Aslınur , Tezer, Hasan , Bayram Ilıkan, Gülşah , Cinel, Güzin , Öztorun, Can İhsan , Bostancı, Süleyman Arif , Şahin, Vildan Selin , Şenel, Emrah . "Pleural empyema and fibrinolytic therapy in children: A single center experience". Türkiye Çocuk Hastalıkları Dergisi / (August 2019): 1-8 . https://doi.org/10.12956/tchd.523491
AMA KANIK YÜKSEK S , Gülhan B , Özkaya Parlakay A , Tezer H , Bayram Ilıkan G , Cinel G , Öztorun C , Bostancı S , Şahin V , Şenel E . Pleural empyema and fibrinolytic therapy in children: A single center experience. Türkiye Çocuk Hast Derg. 2019; 1-8.
Vancouver KANIK YÜKSEK S , Gülhan B , Özkaya Parlakay A , Tezer H , Bayram Ilıkan G , Cinel G , Öztorun C , Bostancı S , Şahin V , Şenel E . Pleural empyema and fibrinolytic therapy in children: A single center experience. Türkiye Çocuk Hastalıkları Dergisi. 2019; 8-1.