Randomised trial of intrapleural urokinase in the treatment of childhood empyema

Thomson, A. H.; Hull, J.; Kumar, M. R.; Wallis, C.; Lynn, I. M. Balfour
April 2002
Thorax;Apr2002, Vol. 57 Issue 4, p343
Academic Journal
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 randomized to receive either intrapleural urokinase 40 000 units in 40 ml or saline 1 2 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, Cl 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, Cl 4.6 to 7.8). Conclusion: Intrapleural urokinase is effective in treating empyema in children and significantly shortens hospital stay.


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