Liječenje djece s patološkim sadržajem u prsištu

Abstract. Objective: To determine the treatment methods and complications in children admitted to Pediatric Intensive Care Unit (PICU) due to pathological contents in the chest. The aim is also to determine the indications for pleural drainage placement, placement techniques, to analyze additional specific therapeutic procedures performed during pleural drainage, the duration of treatment and complications. Subjects and methods: Subjects are all children from birth to 18 years of age with pathological contents in the chest admitted to Pediatric Intensive Care Unit (PICU), Clinical Hospital Center Rijeka, in the period from January 1, 2014 – December 31, 2018. Data were collected and analyzed from archived medical records, integrated hospital information system, and patient admission protocols, and then statistically processed. Results: In the examined period, 1044 children were admitted to PICU; of these, 114 children had pathological contents in the chest (10.9%). The pleural drain was placed in 93 children (95.6%) 53 girls and 40 boys. Indications for pleural drainage were parapneumonic effusion (N = 44, 47.3%), pneumothorax (N = 37, 39.7%), chylothorax (N = 11, 11.8%) and malignant effusion (N = 1, 1.1%) The most common pleural drainage placement technique in the PICU was via the troacar, followed by Seldinger technique. Fibrinolytic therapy was given to eight children with loculated effusion. There were no acute complications during drain insertion. The most common later complication, in 23 children, was drain malposition. Conclusion: Most children admitted to PICU due to pathological contents in the chest are treated with pleural drainage The most common indication for pleural drainage placement in our institution was parapneumonic effusion.