Abstract
This review aims to discuss the role of medical and surgical therapy in the management of pediatric empyema. There is considerable debate on the optimal treatment for the same. Early intervention is crucial as it allows rapid recovery of these patients. Antibiotics and adequate pleural drainage form the two pillars in the management of empyema. Chest tube drainage alone has significant failure rates due to its inability to clear loculated effusion. The two main modalities which target these loculations to augment drainage are video-assisted thoracoscopic surgery (VATS) and intrapleural fibrinolytic therapy. The latest evidence shows that both these interventions are equally effective. Children who present late are usually not candidates for intrapleural fibrinolytic therapy or VATS; for them, decortication remains the only option.
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AM reviewed the literature and drafted the initial manuscript; instead of. RL conceptualized the manuscript, reviewed the literature, and finalized the manuscript. Both authors contributed to the writing of the manuscript and approved the final version of the manuscript. RL shall act as the guarantor for this manuscript.
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Manoharan, A., Lodha, R. Debate 1: Is the Management of Childhood Empyema Primarily Medical, or Surgical?. Indian J Pediatr 90, 910–914 (2023). https://doi.org/10.1007/s12098-023-04576-y
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DOI: https://doi.org/10.1007/s12098-023-04576-y