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Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains
BACKGROUND: Chest tube drainage with fibrinolytics is a cost-effective treatment option for parapneumonic effusion and empyema in children. Although the additional use of ultrasound (US) guidance is recommended, this is rarely performed in real time to direct drain insertion. OBJECTIVE: To evaluate...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105150/ https://www.ncbi.nlm.nih.gov/pubmed/29951836 http://dx.doi.org/10.1007/s00247-018-4171-3 |
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author | Lewis, Megan R. Micic, Thomas A. Doull, Iolo J. M. Evans, Alison |
author_facet | Lewis, Megan R. Micic, Thomas A. Doull, Iolo J. M. Evans, Alison |
author_sort | Lewis, Megan R. |
collection | PubMed |
description | BACKGROUND: Chest tube drainage with fibrinolytics is a cost-effective treatment option for parapneumonic effusion and empyema in children. Although the additional use of ultrasound (US) guidance is recommended, this is rarely performed in real time to direct drain insertion. OBJECTIVE: To evaluate the effectiveness and safety of real-time US-guided, radiologically placed chest drains at a tertiary university hospital. MATERIALS AND METHODS: This was a retrospective review over a 16-year period of all children with parapneumonic effusion or empyema undergoing percutaneous US-guided drainage at our centre. RESULTS: Three hundred and three drains were placed in 285 patients. Treatment was successful in 93% of patients after a single drain (98.2% success with 2 or 3 drains). Five children had peri-insertion complications, but none was significant. The success rate improved with experience. Although five patients required surgical intervention, all children treated since 2012 were successfully treated with single-tube drainage only and none has required surgery. CONCLUSION: Our technique for inserting small-bore (≤8.5 F) catheter drains under US guidance is effective and appears to be a safe procedure for first-line management of complicated parapneumonic effusion and empyema. |
format | Online Article Text |
id | pubmed-6105150 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-61051502018-08-30 Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains Lewis, Megan R. Micic, Thomas A. Doull, Iolo J. M. Evans, Alison Pediatr Radiol Original Article BACKGROUND: Chest tube drainage with fibrinolytics is a cost-effective treatment option for parapneumonic effusion and empyema in children. Although the additional use of ultrasound (US) guidance is recommended, this is rarely performed in real time to direct drain insertion. OBJECTIVE: To evaluate the effectiveness and safety of real-time US-guided, radiologically placed chest drains at a tertiary university hospital. MATERIALS AND METHODS: This was a retrospective review over a 16-year period of all children with parapneumonic effusion or empyema undergoing percutaneous US-guided drainage at our centre. RESULTS: Three hundred and three drains were placed in 285 patients. Treatment was successful in 93% of patients after a single drain (98.2% success with 2 or 3 drains). Five children had peri-insertion complications, but none was significant. The success rate improved with experience. Although five patients required surgical intervention, all children treated since 2012 were successfully treated with single-tube drainage only and none has required surgery. CONCLUSION: Our technique for inserting small-bore (≤8.5 F) catheter drains under US guidance is effective and appears to be a safe procedure for first-line management of complicated parapneumonic effusion and empyema. Springer Berlin Heidelberg 2018-06-27 2018 /pmc/articles/PMC6105150/ /pubmed/29951836 http://dx.doi.org/10.1007/s00247-018-4171-3 Text en © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Lewis, Megan R. Micic, Thomas A. Doull, Iolo J. M. Evans, Alison Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title | Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title_full | Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title_fullStr | Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title_full_unstemmed | Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title_short | Real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
title_sort | real-time ultrasound-guided pigtail catheter chest drain for complicated parapneumonic effusion and empyema in children – 16-year, single-centre experience of radiologically placed drains |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105150/ https://www.ncbi.nlm.nih.gov/pubmed/29951836 http://dx.doi.org/10.1007/s00247-018-4171-3 |
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