[Drug treatment with fibrinolytics (corrected) of secondary empyema secondary to complicated parapneumonic effusion]. / Tratamiento farmacológico con fibrinolíticos [corrected] del empiema secundario a derrame paraneumónico complicado.

ABSTRACT

In recent years we have observed in our country an increase in complications associated with bacterial pneumonia, such as pleural effusion and empyema. The initial treatment is an association of antibiotics, covering the potential germ involved, and the placement of a pleural drainage tube, in order to accelerate the resolution process. Formation of septa within the pleural cavity requires additional therapy (antifibrinolytic treatment, videothorascopy), but no one of these two alternatives is been demonstrated better than the other. We present a review that covers last 15 years (1990-2006), related to management of empyema. The management strategy with initial instillation of antifibrinolytic intrapleural makes our series the longest in our country using such treatment (30 of 50 patients reviewed (60) were treated with this technique). Initial success was 96% with this modality, without rescuing surgery. There is also a descriptive analysis of several clinical, laboratory and radiological parameters. In comparative analysis, length of stay in intensive care unit decreases in those patients treated with antifibrinolytics. This result is a prove of the efficacy of this treatment, and quite encourageing.