Validity of the precocious pleural needle biopsy in patients with Complicated Pneumonia.

Abstract

Pneumonias are one of the most common causes of pleural effusions in children. A 0, 6 – 2 % of pneumonias get complicated with empyema and approximately a 40 percent of pneumonias requiring hospitalization in children present pleural effusion. The treatment is based on the judicious and precocious use of antibiotics, image techniques, thoracocentesis and pleural drainage. The moment of execution of the thoracocentesis or pleural drainage is determined in our medical center by the surgeon and it has always been a motive of controversies. The pleural ultrasound has been determinant for the evaluation of the presence of effusion, its possible quantity and its characteristics. An effusion under 30 ml was considered an effusion of scarce quantity, independently of the age, and those over this number were all evacuated. The evolution of the patients, whose effusion is evacuated during the first 24 hours after the diagnosis, is favorable, reducing the development of pleural and parenchymal complications and hospital staying in direct relation with this procedure. 92, 6 percent of the patients precociously punctured were in the hospital less than 20 days. A fundamental fact for a better evolution of the patients with Complicated Acute Inflammatory Pneumonia is the precocious realization of the evacuating pleural function. The most serious complications in the course of this entity are related with delaying this therapeutic procedure.