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Prospective evaluation of lung function in children with parapneumonic empyema
Author(s) -
de Benedictis Fernando M.,
Carloni Ines,
Osimani Patrizia,
Cobellis Giovanni,
Martino Ascanio,
Lanza Cecilia,
Niccoli Antonio A.,
Azzari Chiara,
Skrami Edlira,
Gesuita Rosaria
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24204
Subject(s) - medicine , empyema , spirometry , prospective cohort study , pulmonary function testing , etiology , population , streptococcus pneumoniae , surgery , lung , pediatrics , asthma , antibiotics , environmental health , microbiology and biotechnology , biology
Rationale Prospective studies that evaluated the outcome of childhood empyema are limited. Objective To compare the outcome of pulmonary function in children with empyema. Patients and Methods Children discharged with a diagnosis of empyema underwent a longitudinal study including measurement of pulmonary function and radiographic imaging. Results The population consisted of 39 patients, 24 males, and 15 females; with a median age of 4.6 years. Etiology was defined in 20/39 patients, and predominant microorganism was Streptococcus pneumoniae (19/20 isolates). Chest tube drainage with or without fibrinolytic agents was the primary intervention in 25 children. Video‐assisted thoracoscopic surgery was performed in 14 and 5 children as primary and secondary intervention, respectively. Thirty‐five children completed the lung function follow‐up. At first follow‐up visit, 5 out of 17 children able to perform spirometry (initially collaborating children) had normal tests, and 12 had mild‐to‐moderate defects of lung function that returned to normal over 2–57 months. Eighteen children unable to perform spirometry at first follow‐up visit (initially non‐collaborating children) had normal tests when they were evaluated 5–78 months postdischarge. At the end of the follow‐up, all patients had normal lung function. Time to normalize did not differ between groups receiving different treatments (initially collaborating children, P = 0.064; initially non‐collaborating children P = 0.223). Three previously healthy children had recurrent cough, and all children had normal chest radiographs aside from pleural thickening. Conclusions The respiratory outcome in children with empyema is generally good and is not influenced by the type of intervention.