Empyema with Dr. Aaron Garrison скачать в хорошем качестве

Empyema with Dr. Aaron Garrison

Pediatric empyema pneumonia is a lung infection that occurs when pus collects in the pleural space, the area between the lungs and chest wall. Symptoms include fever, cough, chest pain, and difficulty breathing. In this video, we cover the management of pediatric empyema, including diagnosis, treatment algorithms, imaging, and surgical versus non-surgical approaches with Dr. Aaron Garrison, a pediatric surgeon at Cincinnati Children’s. Host: Brittany Levy Key Takeaways: • Pediatric empyema pneumonia requires a combination of medical and surgical management, but decision-making can be complex. • Community-acquired pneumonia is a leading cause of hospitalization in children, yet bacterial pathogens are detected in only 15% of cases. • Empyema progresses in three stages: exudative, fibrinopurulent, and organizing. The fibrinopurulent stage is when surgical intervention is often needed. • Ultrasound is more sensitive than CT in detecting septations in pleural effusions and avoids radiation exposure. • Chest tube drainage with fibrinolytics (such as TPA) has been shown to be a viable alternative to VATS, reducing hospital stays and costs. • Some children with effusions may not require TPA—clinical improvement within 24 hours of drainage can indicate that it’s unnecessary. • Inhaled foreign bodies, particularly peanuts, can mimic pneumonia and require a high index of suspicion for proper diagnosis. • CT scans are now being used to diagnose airway foreign bodies with high reliability, reducing unnecessary bronchoscopies. • Pulmonary abscesses in otherwise healthy children often resolve with antibiotics alone and rarely require drainage. Further reading: https://api.semanticscholar.org/Corpu... Module 2 . Hemodynamic Disorders, 2015 https://thoracickey.com/nonmalignant-... Nonmalignant Pleural Effusions by John E. Heffner https://www.ctsnet.org/article/thorac... Thoracoscopic Decortication by Christopher Komanapalli https://publications.aap.org/neorevie... A Newborn with a Cyst in the Lung by Shabih Manzar, MD; Liaqat H. Khan, MD https://journals.lww.com/ascp/fulltex... Singh, Sarvinder; Singh, Santosh Kumar; Tentu, Ajai Kumar. Management of parapneumonic effusion and empyema. The Journal of Association of Chest Physicians 7(2):p 51-58, Jul–Dec 2019. | DOI: 10.4103/jacp.jacp_24_18 https://pubmed.ncbi.nlm.nih.gov/23164... Islam S, Calkins CM, Goldin AB, Chen C, Downard CD, Huang EY, Cassidy L, Saito J, Blakely ML, Rangel SJ, Arca MJ, Abdullah F, St Peter SD; APSA Outcomes and Clinical Trials Committee, 2011-2012. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg. 2012 Nov;47(11):2101-10. doi: 10.1016/j.jpedsurg.2012.07.047. PMID: 23164006. https://pubmed.ncbi.nlm.nih.gov/31973... Derderian SC, Meier M, Partrick DA, Demasellis G, Reiter PD, Annam A, Bruny J. Pediatric empyemas - Has the pendulum swung too far? J Pediatr Surg. 2020 Nov;55(11):2356-2361. doi: 10.1016/j.jpedsurg.2019.12.017. Epub 2019 Dec 30. PMID: 31973927. https://pubmed.ncbi.nlm.nih.gov/26382... Long AM, Smith-Williams J, Mayell S, Couriel J, Jones MO, Losty PD. 'Less may be best'-Pediatric parapneumonic effusion and empyema management: Lessons from a UK center. J Pediatr Surg. 2016 Apr;51(4):588-91. doi: 10.1016/j.jpedsurg.2015.07.022. Epub 2015 Aug 12. PMID: 26382287. Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-cur...