Validação de escore e analise de variaveis indicativas de drenagem pleural em crianças e adolescentes com derrame pleural parapneumonico

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

The terapeutic decisions for parapneumonic efusion (PPE) in children are still controversial. A partnership between pediatricians and surgeons arised an indicative score to chest-tube drainage. This research aims to evaluate the score usage and the PPE treatment. This is a retrospective cross-section study with 250 pacients with PPE at the pediatric ward between 1994 at 1999. The following variables were analysed: clinical conditions, chest radiographs, pleural fluid bacteriology, pleural fluid chemistry, score and treatment. The score was based in four categories: a)- appearance of the pleural liquid; b)- chest radiographies; c)- laboratory fidings; d)- second thoracocentesis. If the score is over 5,5, drainage would be recommended. PPE ocurred in 32,2% (304) of 941 children with pneumonia; 58,4% were male. The mean of age was 3,0 years old and median of 2,0 years old. The cut-off-point obtained at R.O.C. curve to suggest pleural drainage was: pH?7,29 (sensibility of 89,2% and specifity of 76,5%), score?5,0 (sensibility of 64,3% and specifity of 78,1%) and the glucose ?45mg% (sensibility of 68,7% and specificity of 81,7%). The LDH wasn?t a good method for the terapeutic decision. Concluded that apart of purulent aspect, pH?7,29 is the best indicative for chest drainaige in paediatric pacients; over there score isn?t better than pH pleural, but how it?s good to indicate drainage to PPE, request adjusting

ASSUNTO(S)

liquidos torax - doenças tratamento

ACESSO AO ARTIGO

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