BACKGROUND: Progression of @entity3509 , with the development of fibrinous adhesions and loculations, makes simple drainage difficult or impossible. The appropriate management remains controversial. Intrapleural fibrinolytic treatment to facilitate drainage of @entity3509 instead of open thoracotomy has been advocated since the 1950s. The aim of this study was to assess the effectiveness of intrapleural fibrinolytic treatment in @entity3509 . METHODS: In our clinic, we used intrapleural fibrinolytic agents in 72 pediatric @entity1 with multiloculated @entity3509 between 1994 and 2002. Streptokinase, 250,000 U in 100 mL of 0.9% saline solution (59 @entity1 ), and urokinase, 100,000 U in 100 mL of 0.9% saline solution (13 @entity1 ), were instilled daily into the chest tube, and the tube was clamped for 4 hours followed by suction. This treatment was continued daily for 2 to 10 days until resolution was demonstrated by chest radiograms or computed chest tomography. RESULTS: The rate of drainage after fibrinolytic treatment was increased 73.77%. Treatment was ineffective in 14 (19.44%) of 72 @entity1 who underwent fibrinolytic instillation. Treatment was discontinued because of @entity56 and @entity548 in 1 @entity1 , and because of development of @entity292 in another one. The regimen was completely successful in 43 (59.72%) @entity1 , and partially successful in another 15 (20.83%). Twelve of those @entity1 who had failure eventually required decortication and recovered completely. One @entity1 died of sepsis and @entity548 ; another @entity1 died because of food aspiration. CONCLUSIONS: In all @entity1 with loculations except those with a @entity292 , intrapleural fibrinolytic treatment should be tried. Thus, the majority of @entity1 with loculated empyemas can be treated successfully without invasive interventions, such as thoracoscopic debridements or open surgery.

Intrapleural fibrinolytic treatment of multiloculated XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['pleural hemorrhage'] @entity3509 :: ('MESH:D004653', 'Disease') :: ['empyema', 'loculated empyema', 'postpneumonic pediatric empyemas'] @entity292 :: ('MESH:D005402', 'Disease') :: ['bronchopleural fistula'] @entity56 :: ('MESH:D004342', 'Disease') :: ['allergic reaction']
@entity3509 :: (MESH:D004653,Disease) :: ['postpneumonic pediatric empyemas']
