PT  - JOURNAL ARTICLE
AU  - Thomson, A H
AU  - Hull, J
AU  - Kumar, M R
AU  - Wallis, C
AU  - Balfour Lynn, I M
TI  - Randomised trial of intrapleural urokinase in the treatment of childhood empyema
AID  - 10.1136/thorax.57.4.343
DP  - 2002 Apr 01
TA  - Thorax
PG  - 343--347
VI  - 57
IP  - 4
4099  - http://thorax.bmj.com/content/57/4/343.short
4100  - http://thorax.bmj.com/content/57/4/343.full
SO  - Thorax2002 Apr 01; 57
AB  - Background: The role of intrapleural fibrinolytic agents in the treatment of childhood empyema has not been established. A randomised double blind placebo controlled trial of intrapleural urokinase was performed in children with parapneumonic empyema. Methods: Sixty children (median age 3.3 years) were recruited from 10 centres and randomised to receive either intrapleural urokinase 40 000 units in 40 ml or saline 12 hourly for 3 days. The primary outcome measure was length of hospital stay after entry to the trial. Results: Treatment with urokinase resulted in a significantly shorter hospital stay (7.4 v 9.5 days; ratio of geometric means 1.28, CI 1.16 to 1.41 p=0.027). A post hoc analysis showed that the use of small percutaneous drains was also associated with shorter hospital stay. Children treated with a combination of urokinase and a small drain had the shortest stay (6.0 days, CI 4.6 to 7.8). Conclusion: Intrapleural urokinase is effective in treating empyema in children and significantly shortens hospital stay.