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. 2002 Apr;57(4):343–347. doi: 10.1136/thorax.57.4.343

Randomised trial of intrapleural urokinase in the treatment of childhood empyema

A Thomson 1, J Hull 1, M Kumar 1, C Wallis 1, L Balfour 1
PMCID: PMC1746300  PMID: 11923554

Abstract

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.

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Selected References

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