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Purpose <p>To evaluate real-world effectiveness of intrapleural fibrinolysis versus drainage alone or surgery, and to identify factors linked to prolonged hospitalisation in children with pleural empyema at a tertiary centre. We also aimed to provide regional baseline data to guide future care.</p> Methods <p>We retrospectively reviewed records for all patients aged ≤ 14&#xa0;years treated for pleural empyema et al.&#xa0;Jalila Children’s Specialty Hospital, Dubai, from January&#xa0;2021 to December&#xa0;2024. Demographics, imaging, treatments, antibiotic use, and in-hospital outcomes were abstracted and summarised descriptively.</p> Results <p>Thirty-five children (median age&#xa0;4&#xa0;years; 54% female) were included. All underwent ultrasound-guided tube thoracostomy, and 30&#xa0;(86%) also received intrapleural alteplase. Four children needed surgical decortication and 1 child with lymphoma died. Median tube drainage was 6&#xa0;days with fibrinolysis versus 8&#xa0;days without. Median hospital stay was 11&#xa0;days with fibrinolysis, 27&#xa0;days without, and 13.5&#xa0;days after surgery. Hospitalisation ≥ 15&#xa0;days correlated with older age, omission of fibrinolysis, use of ≥ 4 antibiotics, and computed tomography imaging. No serious drug-related adverse events occurred. </p> Conclusion <p>Prompt tube thoracostomy combined with intrapleural alteplase is a safe, effective, and resource-efficient first-line therapy for paediatric empyema, shortening hospital stay and markedly reducing the need for surgery.</p>

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Treatment outcomes in pediatric empyema: a retrospective observational study from a tertiary center in Dubai, United Arab Emirates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月12日

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  • Mohammed Al Blooshi,
  • Munir Ahmad,
  • Fadi Al Shamali,
  • Wajeeh Uddin,
  • Ghadir Jaber,
  • Mamoun Al Marzouqi,
  • Avinash Hiremath,
  • Masih Abdul Kader,
  • Vipul Gupta

摘要

Purpose

To evaluate real-world effectiveness of intrapleural fibrinolysis versus drainage alone or surgery, and to identify factors linked to prolonged hospitalisation in children with pleural empyema at a tertiary centre. We also aimed to provide regional baseline data to guide future care.

Methods

We retrospectively reviewed records for all patients aged ≤ 14 years treated for pleural empyema et al. Jalila Children’s Specialty Hospital, Dubai, from January 2021 to December 2024. Demographics, imaging, treatments, antibiotic use, and in-hospital outcomes were abstracted and summarised descriptively.

Results

Thirty-five children (median age 4 years; 54% female) were included. All underwent ultrasound-guided tube thoracostomy, and 30 (86%) also received intrapleural alteplase. Four children needed surgical decortication and 1 child with lymphoma died. Median tube drainage was 6 days with fibrinolysis versus 8 days without. Median hospital stay was 11 days with fibrinolysis, 27 days without, and 13.5 days after surgery. Hospitalisation ≥ 15 days correlated with older age, omission of fibrinolysis, use of ≥ 4 antibiotics, and computed tomography imaging. No serious drug-related adverse events occurred.

Conclusion

Prompt tube thoracostomy combined with intrapleural alteplase is a safe, effective, and resource-efficient first-line therapy for paediatric empyema, shortening hospital stay and markedly reducing the need for surgery.