Lung functions during long term follow-up after pleural empyema treatment in children

Abstract

Introduction: Studies on lung functions at the long term follow-up of pleural empyema treatment in children are limited. The aim of this study was to evaluate the long term pulmonary function test results in childhood empyema cases treated with antibiotic (AB) or AB+tube thoracostomy (TT) or AB+TT+fibrinolytics (FT).Materials and Method: In this study, 45 cases (1 to 13 years old) treated for empyema were included. The age, gender, clinical characteristics, radiological findings and laboratory results at baseline and during the follow-up periods and the treatment modalities (AB or AB+TT or AB+TT+FT) were evaluated. Pulmonary function tests were performed at the end of the follow-up periods.Results: The mean ages at baseline and at the end of follow-up period of 30.4 +/- 13.5 (6-54) months were 6.3 +/- 3.3 (1-13) years and 9.3 +/- 3.4 (4-17) years, respectively. Stages of the disease at admission was acute exudative (stage 1) in 14 (31.1%) cases, fibrinopurulent (stage 2) in 19 (42.2%) and chronic organizing (stage 3) in 12 (26.7%). Twenty one cases (46.7%) were treated with AB, 8 (17.8%) with AB+TT and 16 (35.5%) with AB+TT+FT. Chest roentgenograms showed abnormal findings in 15 cases (33.3%) at the 3rd month, in 3 cases (6.6%) at the 6th month and none at the 12th month. Pulmonary function tests were available in 25 children. The mean follow-up period of these cases was 32.7 +/- 11.9 months after the empyema treatment. Three cases (12%) with a shorter mean follow-up (8.3 +/- 3.3 months) had minimal restrictive patterns. Six of 25 (24%) cases having pulmonary function tests were classified as stage 1, 12 (48%) as stage 2, and 7 (28%) as stage 3 empyema at admission. Of 25 cases having pulmonary function tests, 12 (48%) were treated with AB, 4 (16%) with AB+TT and 9 (36%) with AB+TT+FT. Mean VC, FVC, FEV1/FVC, FEV1, FEF25-75% and PEF values did not significantly differ according to stages and treatment modalities (p>0.05).Conclusion: It was seen that after the treatment of empyema, remarkable improvements were seen in chest roentgenographic findings between 3rd and 6th months and in general, pulmonary function tests revealed normal results in long term. Our results suggest that lung functions are not significantly compromised at long term after empyema treatment.