应用胸膜内阿替普酶治疗儿童肺旁积液:10年经验报告。

Q2 Medicine
Yusuf M Garwan, Muath A Alsalloum, A Jill Thompson, Taylor Morrisette, Katherine H Chessman
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引用次数: 0

摘要

目的:胸腔内注射阿替普酶用于儿童肺旁积液(PPE)的不同剂量策略。我们比较了低剂量(≤2mg)和高剂量(≤2mg)阿替普酶对PPE患儿的治疗效果。方法:回顾性研究2014年7月至2023年5月期间接受1次以上胸腔内阿替普酶治疗的18岁以下住院患者。主要观察指标是治疗失败率。次要结局包括胸管输出量、放置时间以及医院和儿科重症监护病房(PICU)的住院时间。结果:纳入72例患者(低剂量:62.5% vs高剂量:37.5%),中位年龄为5岁(IQR, 1-8岁)。阿替普酶中位剂量为2 mg (IQR, 2-4 mg)。10例(14%)患者出现治疗失败。低剂量组的失败率与高剂量组相似(低剂量组为9%,高剂量组为22%,p = 0.161),尽管高剂量组的中位胸管输出量更高(346 [IQR, 256-466]对175 [IQR, 70-358] mL/24h, p = 0.002)。然而,在调整体重后,两组的输出量相似(12 mL/kg/24h)。初次视频辅助胸腔镜手术(VATS)后滴注阿替普酶与胸管放置时间、住院时间和PICU住院时间显著缩短相关。结论:低剂量阿替普酶(≤2mg)对大多数PPE患儿有效。阿替普酶联合原发性VATS可能与更好的结果相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Intrapleural Alteplase in the Treatment of Parapneumonic Effusion in Children: A Report of a 10-year Experience.

Objectives: Intrapleural alteplase is used in children with parapneumonic effusion (PPE) with variable dosing strategies. We compared the outcomes of a lower (≤2 mg) and a higher (>2 mg) alteplase dose in children with PPE.

Methods: A retrospective study was conducted among admitted patients younger than 18 years who received at least 1 intrapleural alteplase dose from July 2014 to May 2023. The primary outcome was the treatment failure rate. Secondary outcomes included chest tube output and duration of placement and hospital and pediatric intensive care unit (PICU) length of stays.

Results: Seventy-two patients were included (lower dose: 62.5% vs higher dose: 37.5%) with a median age of 5 years (IQR, 1-8 years). The median alteplase dose was 2 mg (IQR, 2-4 mg). Treatment failure occurred in 10 (14%) patients. The lower dose group had a similar failure rate compared with the higher dose group (lower dose: 9% vs higher dose: 22%; p = 0.161), despite a statistically significant higher median chest tube output in the higher dose group (346 [IQR, 256-466] vs 175 [IQR, 70-358] mL/24h; p = 0.002). However, after adjusting for weight, both groups had a similar output (12 mL/kg/24h). Alteplase instillation after primary video-assisted thoracoscopic surgery (VATS) was associated with a significant reduction in the duration of chest tube placement and hospital and PICU stays.

Conclusions: Lower alteplase doses (≤2 mg) were effective for most children with PPE. Alteplase combined with primary VATS might be associated with better outcomes.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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