Role of Intrapleural Streptokinase in Children with Empyema - Randomised Controlled Trial
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 11
Abstract
Introduction: Collection of pus like material in the pleural space is known as empyema and it generally occurs as a serious complication of pneumonia. Empyema generally occurs in children after pneumonia of acute bacterial origin and it is generally associated with significant morbidity and mortality. The main aim of the present study was to determine the perks and advantages of adding intrapleural streptokinase to the conventional therapy for managing cases of childhood empyema. Material and methods: The present retrospective study was conducted in the Department, Institute, State during a period of 2 years. The study consisted of 20 subjects that were admitted to the hospital with the complaint of pneumonia complicated by empyema. Chest radiograph, ultrasound or CT scan was performed as required based on the patients conditions. Pleural fluid culture and analysis was done in empyema cases. Initial diagnostic thoracocentesis was performed amongst all the patients with 14 gauge venula on admission to hospital. Further biochemical analysis of the sample was done. Levels of LDH, glucose and protein were determined. The criteria’s of comparison were duration of chest tube drainage, stay in hospital, fever and decrease in incidence of hospital stay were considered as successful treatment. All the data was arranged in a tabulated form and analysed using SPSS software. Chi square test and mann Whitney test was used for comparison. Probability value of less than 0.05 was considered significant. Results: The study enrolled total of 20 subjects, out of these 10 belonged to conventional group and 10 were administered intrapleural streptokinase. The mean age of the subjects in conventional group was 4.3 +/- 2.4 years and in the streptokinase group was 3.6 +/- 2.2 years. The male to female ration in conventional group was 3:2 and in the streptokinase group was 4:1. The mean hospital stay in conventional group was 19.3 +/-5.7 days and in streptokinase group was 18.9 +/- 4.8. The mean duration of hospital stay after surgery was 9.6 +/-2.1 and 8.5 +/- 3.5 in the conventional and streptokinase group respectively. Duration of afebrile state after surgery was 6.4 +/- 2.3 and 5.2 +/- 4.1 in the conventional and streptokinase groups respectively. Conclusion: From the above study that Effect of streptokinase is better that emperical therapy. it is clear that addition of intrpleural streptokinase along with the conventional therapy provides no additional advantage. Effect of streptokinase is better that emperical therapy.
Authors and Affiliations
Ekta Singh, Anuj Kumar, D. Y. Shrikhande, P. Nigwekar
Keywords
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