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

Journal article

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: Thomson, A; Hull, J; Kumar, MR; Wallis, C; Balfour Lynn, I

• Publication status: Published
• Journal: Thorax
• Volume: 57
• Issue: 4
• Pages: 343-347
• Publication date: 2002-04-01
• DOI: 10.1136/thorax.57.4.343
• EISSN: 1468-3296
• ISSN: 0040-6376
• Language: English
• Keywords: Adolescent; Infant; Treatment Outcome; Survival Analysis; Empyema; Urokinase-Type Plasminogen Activator; Child; Regression Analysis; Child, Preschool; Double-Blind Method; Follow-Up Studies; Length of Stay; Humans; Plasminogen Activators