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Lung Function in Children Following Empyema

Lung Function in Children Following Empyema Abstract • Spirometry was performed and response to exercise was measured in 15 children following recovery from empyema to evaluate the impact of pleural infection on subsequent lung function. Seven children underwent chest tube drainage; eight did not. The two groups were similar in age (mean±SD, 6±5 years), sex distribution, bacterial pathogen—producing empyema, and age at follow-up evaluation (12±5 years). Only one child reported recurrent respiratory symptoms. No child had restrictive spirometric changes (total lung capacity, 80%; vital capacity, 80% predicted) but seven of 15 had a reduced forced expiratory volume in 1 second (<80% predicted) or forced expiratory flow during the middle half of the vital capacity (<75% predicted), suggesting mild airway obstruction. No child demonstrated reduced exercise tolerance due to restrictive ventilatory limitations. Mild obstructive abnormalities in lung function were identified with equal frequency in children treated with and without chest tube drainage. (AJDC. 1990;144:1337-1342) References 1. Stern RC. The respiratory system . In: Behrman RE, Vaughn VC, eds. Nelson Textbook of Pediatrics . 13th ed. Philadephia, Pa: WB Saunders Co; 1987:937-938. 2. Freij BJ, Kusmiesz H, Nelson JD, McCracken GH. Parapneumonic effusions and empyema in hospitalized children: a retrospective review of 227 cases . Pediatr Infect Dis J . 1984;3:578-591.Crossref 3. Tooley WT, Lipow HM. Lung diseases in children . In: Rudolph AM, ed. Pediatrics . Norwalk, Conn: Appleton & Lange; 1987;1428-1429. 4. Grant DR, Finley RJ. Empyema: analysis of treatment techniques . Can J Surg . 1985;28:449-451. 5. Murty TVM, Rao VS, Kusuma G, Reddi YR, Marar GS. Empyema thoracis in children . Indian J Pediatr . 1973;40:240-245.Crossref 6. Narayanan I, Krishnakumari VS, Balakrishnan S, Narayanan PS. A study of empyema in infancy and childhood . Indian Pediatr . 1972;9:621-626. 7. Grossman D. Fibrothorax . In: Cherniack RM, ed. Current Therapy of Respiratory Disease 2 . Philadelphia, Pa: BC Decker Inc; 1986:242-244. 8. Murphy D, Lockhart CH, Todd JK. Pneumococcal empyema outcome of medical management . AJDC . 1980;134:659-662. 9. Hartl H. Pleuropulmonary suppurations . Prog Pediatr Surg . 1977;10:257-266. 10. Meyerovitch J, Shohet I, Rubinstein E. Analysis of thirty-seven cases of pleural empyema . EurJ Clin Microbiol Infect Dis . 1985;4:337-339. 11. Stiles QR, Lindesmith GG, Tucker BL, Meyer BW, Jones JC. Pleural empyema in children . Ann Thorac Surg . 1970;10:37-44.Crossref 12. Huxtable KA, Tucker AS, Wedgewood RJ. Staphylococcal pneumonia in childhood . AJDC . 1964;108:262-269. 13. Smith PL, Gerald B. Empyema in childhood followed roentgenographically: decortication seldom needed . Am J Radiol . 1969;106:114-117. 14. Polgar G, Promadhat V. Standard values . In: Pulmonary Function Testing in Children: Techniques and Standards . Philadelphia, Pa: WB Saunders Co; 1971:87-211. 15. James FW, Kaplan S, Glueck CJ, Tsay J, Knight MJS, Sarwar CJ. Responses of normal children and young adults to controlled bicycle exercise . Circulation . 1980;61:902-912.Crossref 16. Jones NL, Campbell EJM. Normal standards . In: Jones NL, Campbell EJM, eds. Clinical Exercise Testing . Philadelphia, Pa: WB Saunders Co; 1975;28:249-253. 17. Wasserman K, Hansen JE, Sue DY, Whipp BJ. Principles of Exercise Testing and Interpretation . Philadelphia, Pa: Lea & Febiger; 1987:91-92. 18. James FW, Blomquist CG, Freed MD, et al. Standard of exercise testing in the pediatric age group . Circulation . 1982;66:1377A-1397A. 19. McLaughlin FJ, Goldmann DA, Rosenbaum DR, Harris GBL, Schuster SR, Strieder DJ. Empyema in children: clinical course and long-term follow-up . Pediatrics . 1984;73:587-593. 20. Kattan M. Long-term sequelae of respiratory illness in infancy and childhood . Pediatr Clin North Am . 1979;26:525-537. 21. Santoshan M, Chipps BE, Strife JL, et al. Sequelae of H. influenza type b empyema . J Pediatr . 1979;95:160-161.Crossref 22. Wise MB, Beaudry PH, Bates DV. Longterm follow-up of staphylococcal pneumonia . Pediatrics . 1966;38:398-401. 23. Groff DB, Randolph JG, Blades B. Empyema in childhood . JAMA . 1966;14:164-166. 24. Bartlett JG, Thadepalli H, Gorbach SL, Feingold SM. Bacteriology of empyema . Lancet . 1974;1:338-340.Crossref 25. Kosloske AM, Cushing AH, Shuck JM. Early decortication for anaerobic empyema in children . J Pediatr Surg . 1980;15:422-429.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Lung Function in Children Following Empyema

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1990.02150360063021
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Abstract

Abstract • Spirometry was performed and response to exercise was measured in 15 children following recovery from empyema to evaluate the impact of pleural infection on subsequent lung function. Seven children underwent chest tube drainage; eight did not. The two groups were similar in age (mean±SD, 6±5 years), sex distribution, bacterial pathogen—producing empyema, and age at follow-up evaluation (12±5 years). Only one child reported recurrent respiratory symptoms. No child had restrictive spirometric changes (total lung capacity, 80%; vital capacity, 80% predicted) but seven of 15 had a reduced forced expiratory volume in 1 second (<80% predicted) or forced expiratory flow during the middle half of the vital capacity (<75% predicted), suggesting mild airway obstruction. No child demonstrated reduced exercise tolerance due to restrictive ventilatory limitations. Mild obstructive abnormalities in lung function were identified with equal frequency in children treated with and without chest tube drainage. (AJDC. 1990;144:1337-1342) References 1. Stern RC. The respiratory system . In: Behrman RE, Vaughn VC, eds. Nelson Textbook of Pediatrics . 13th ed. Philadephia, Pa: WB Saunders Co; 1987:937-938. 2. Freij BJ, Kusmiesz H, Nelson JD, McCracken GH. Parapneumonic effusions and empyema in hospitalized children: a retrospective review of 227 cases . Pediatr Infect Dis J . 1984;3:578-591.Crossref 3. Tooley WT, Lipow HM. Lung diseases in children . In: Rudolph AM, ed. Pediatrics . Norwalk, Conn: Appleton & Lange; 1987;1428-1429. 4. Grant DR, Finley RJ. Empyema: analysis of treatment techniques . Can J Surg . 1985;28:449-451. 5. Murty TVM, Rao VS, Kusuma G, Reddi YR, Marar GS. Empyema thoracis in children . Indian J Pediatr . 1973;40:240-245.Crossref 6. Narayanan I, Krishnakumari VS, Balakrishnan S, Narayanan PS. A study of empyema in infancy and childhood . Indian Pediatr . 1972;9:621-626. 7. Grossman D. Fibrothorax . In: Cherniack RM, ed. Current Therapy of Respiratory Disease 2 . Philadelphia, Pa: BC Decker Inc; 1986:242-244. 8. Murphy D, Lockhart CH, Todd JK. Pneumococcal empyema outcome of medical management . AJDC . 1980;134:659-662. 9. Hartl H. Pleuropulmonary suppurations . Prog Pediatr Surg . 1977;10:257-266. 10. Meyerovitch J, Shohet I, Rubinstein E. Analysis of thirty-seven cases of pleural empyema . EurJ Clin Microbiol Infect Dis . 1985;4:337-339. 11. Stiles QR, Lindesmith GG, Tucker BL, Meyer BW, Jones JC. Pleural empyema in children . Ann Thorac Surg . 1970;10:37-44.Crossref 12. Huxtable KA, Tucker AS, Wedgewood RJ. Staphylococcal pneumonia in childhood . AJDC . 1964;108:262-269. 13. Smith PL, Gerald B. Empyema in childhood followed roentgenographically: decortication seldom needed . Am J Radiol . 1969;106:114-117. 14. Polgar G, Promadhat V. Standard values . In: Pulmonary Function Testing in Children: Techniques and Standards . Philadelphia, Pa: WB Saunders Co; 1971:87-211. 15. James FW, Kaplan S, Glueck CJ, Tsay J, Knight MJS, Sarwar CJ. Responses of normal children and young adults to controlled bicycle exercise . Circulation . 1980;61:902-912.Crossref 16. Jones NL, Campbell EJM. Normal standards . In: Jones NL, Campbell EJM, eds. Clinical Exercise Testing . Philadelphia, Pa: WB Saunders Co; 1975;28:249-253. 17. Wasserman K, Hansen JE, Sue DY, Whipp BJ. Principles of Exercise Testing and Interpretation . Philadelphia, Pa: Lea & Febiger; 1987:91-92. 18. James FW, Blomquist CG, Freed MD, et al. Standard of exercise testing in the pediatric age group . Circulation . 1982;66:1377A-1397A. 19. McLaughlin FJ, Goldmann DA, Rosenbaum DR, Harris GBL, Schuster SR, Strieder DJ. Empyema in children: clinical course and long-term follow-up . Pediatrics . 1984;73:587-593. 20. Kattan M. Long-term sequelae of respiratory illness in infancy and childhood . Pediatr Clin North Am . 1979;26:525-537. 21. Santoshan M, Chipps BE, Strife JL, et al. Sequelae of H. influenza type b empyema . J Pediatr . 1979;95:160-161.Crossref 22. Wise MB, Beaudry PH, Bates DV. Longterm follow-up of staphylococcal pneumonia . Pediatrics . 1966;38:398-401. 23. Groff DB, Randolph JG, Blades B. Empyema in childhood . JAMA . 1966;14:164-166. 24. Bartlett JG, Thadepalli H, Gorbach SL, Feingold SM. Bacteriology of empyema . Lancet . 1974;1:338-340.Crossref 25. Kosloske AM, Cushing AH, Shuck JM. Early decortication for anaerobic empyema in children . J Pediatr Surg . 1980;15:422-429.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Dec 1, 1990

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