RT Journal Article SR Electronic T1 Randomised trial of intrapleural urokinase in the treatment of childhood empyema JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 343 OP 347 DO 10.1136/thorax.57.4.343 VO 57 IS 4 A1 A H Thomson A1 J Hull A1 M R Kumar A1 C Wallis A1 I M Balfour Lynn YR 2002 UL http://thorax.bmj.com/content/57/4/343.abstract 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.