Randomised trial of intrapleural urokinase in the treatment of childhood empyema.

Abstract

BACKGROUND:

The role of intrapleural fibrinolytic agents in the treatment of childhood empyema has not been established. A randomised double blind placebo controlled trial of intrapleural urokinase was performed in children with parapneumonic empyema.

METHODS:

Sixty children (median age 3.3 years) were recruited from 10 centres and randomised to receive either intrapleural urokinase 40 000 units in 40 ml or saline 12 hourly for 3 days. The primary outcome measure was length of hospital stay after entry to the trial.

RESULTS:

Treatment with urokinase resulted in a significantly shorter hospital stay (7.4 v 9.5 days; ratio of geometric means 1.28, CI 1.16 to 1.41 p=0.027). A post hoc analysis showed that the use of small percutaneous drains was also associated with shorter hospital stay. Children treated with a combination of urokinase and a small drain had the shortest stay (6.0 days, CI 4.6 to 7.8).

CONCLUSION:

Intrapleural urokinase is effective in treating empyema in children and significantly shortens hospital stay.

• Authors: A H Thomson, J Hull, M R Kumar, C Wallis, I M Balfour Lynn
• Journal: Thorax (Thorax) Vol. 57 Issue 4 Pg. 343-7 (Apr 2002) ISSN: 0040-6376 [Print] England
• PMID: 11923554 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Plasminogen Activators
• Urokinase-Type Plasminogen Activator

Topics

• Adolescent
• Child
• Child, Preschool
• Double-Blind Method
• Empyema (drug therapy)
• Follow-Up Studies
• Humans
• Infant
• Length of Stay
• Plasminogen Activators (therapeutic use)
• Regression Analysis
• Survival Analysis
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (therapeutic use)