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Pleural disease in infants and children: management updates

Current Pulmonology Reports volume 5, pages 28–34 (2016)Cite this article

Abstract

Pleural diseases, their management, and outcomes in pediatric setting differ from those of adults. Treatment options vary with the etiology of the pleural process. This article addresses new treatments for congenital hydrothorax and chylothorax, parapneumonic effusions, and spontaneous pneumothoraces in children. Invasive fetal surgical methods to drain pleural fluid in utero improve survival and reduce the chance of postnatal pulmonary hypoplasia. Video-assisted thoracoscopic surgery and intrapleural instillation of fibrinolytic agents produce similar outcomes for children with empyema and/or parapneumonic effusions. Spontaneous primary pneumothoraces in older children and young adults are increasingly treated with drainage methods that prevent or reduce hospitalizations. Newer treatments such as intrapleural combined tissue plasminogen activator and DNAase for empyema and intrapleural catheters attached to Heimlich valves for treatment of spontaneous pneumothoraces have been studied in adults but not yet in children and provide promise for better outcomes in the future.

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Abbreviations

EXIT:

Ex utero intrapartum treatment

IVIG:

Intravenous immunoglobulin

PCV-7:

Pneumococcal conjugate vaccine-7 valent

PCV-13:

Pneumococcal conjugate vaccine-13 valent

VATS:

Video-assisted thoracoscopic surgery

tPA:

Tissue plasminogen activator

PSP:

Primary spontaneous pneumothorax

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Authors and Affiliations

  1. Pulmonary and Sleep Medicine Division, Seattle Children’s Hospital, Office: OC.7.720, 4800 Sand Point Way NE, Seattle, WA, 98105, USA

    Jennifer Soares & Gregory J. Redding

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  1. Jennifer Soares
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  2. Gregory J. Redding
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Correspondence to Gregory J. Redding.

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Jennifer Soares and Gregory J. Redding each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pleural Diseases and Mesothelioma

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Soares, J., Redding, G.J. Pleural disease in infants and children: management updates. Curr Pulmonol Rep 5, 28–34 (2016). https://doi.org/10.1007/s13665-016-0134-z

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