Navegando por Assunto "Derrame pleural"

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Acesso aberto (Open Access)
Derrame Pleural Parapneumônico: perfil e evolução de crianças internadas no Hospital Universitário João de Barros Barreto
(Universidade Federal do Pará, 2012) ARÊAS, Claudia Giselle Santos; NORMANDO, Geraldo Roger; http://lattes.cnpq.br/9822022240199044; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163
Introduction: Pneumonia is one of the most common diseases in children, and pleural effusion is a potential complication, especially in developing countries, where there are limitations in diagnostic and therapeutic resources. Objectives: The aim of this study is to know the profile of the children presenting pleural effusions complicating pneumonia analyzing their evolution regarding the clinical and surgical treatment instituted. Methods: A descriptive, transversal, prospective survey, which studied all children admitted in a Brazilian hospital which is reference in infectious diseases with diagnosis of parapneumonic effusion, submitted to surgery because of this complication, in the period between October of 2010 and October of 2011. Results: The sample was composed by 46 children, mostly younger than 3 years old (74%). A significant part of the sample (28%) had some nutritional inadequacy. The mean of disease duration until the ingress was 16,9 days, the whole sample came from other hospitals. The means of duration of hospital length and febrile state were, 26,0 and 9,8 days, respectively. It was used a media of 2,2 antibiotic schemes, and Ceftriaxone was the most drug most used. Etiological diagnosis was achieved in one single case. In 22 patients, (47,8%), it was observed empyema pleural, and they had a longer drainage duration. It was attested association between stunting and multiple surgeries (G Test = 8,40; p = 0,040). The majority of the children (80,4%) was submitted to surgery just once. The closed thoracic drainage was the most common surgery (85%). The open thoracocentesis was used in 24,0% of the children. The thoracotomy was performed in 2 patients (4,0%). All patients were clinical and radiological reestablished within 4 months after the hospital discharge, and there were not deceases in this sample. Conclusion: the sample studied has advanced disease and common nutritional disturbs, which may influence in surgical evolution. It is necessary antibiotic therapy standardization. Pleurostomy is still a valid option, and new studies are demanded in order to reconsider it, mainly in centers where videothoracoscopy is unavailable.
Acesso aberto (Open Access)
Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital
(Universidade Federal do Pará, 2016-12) ARÊAS, Claudia Giselle Santos; NORMANDO JÚNIOR, Geraldo Roger; FARIAS JUNIOR, Orlando Sandoval; CARNEIRO, Irna Carla do Rosário Souza
Objective: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE), and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD). Methods: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011. Results: we studied 46 patients, most children under three years of age (74%), with no gender predominance. A significant portion of the sample (28%) had inappropriate body mass index. We found short stature in five patients (11%), which tended, in general, to a worst postoperative outcome when compared with children of normal height (p=0.039). The average duration of symptoms till admission was 16.9 days. Empyema was a common diagnosis in the first surgery (47.8%), and its bearers had longer duration of chest tube drainage (p=0.015). Most children (80.4%) were operated only once. The mean length of hospital stay was 25.9 days. Thoracic drainage (water-sealed) was the most common procedure (85%), with conversion to OTD in 24% of the sample, thoracotomy being rare (4%). There were no deaths. Conclusion: the studied individuals often had advanced disease and nutritional disorders, affecting outcome. OTD remains a valid option for specific situations, and further studies are needed for confirmation.