Assessment of lung function improvement among paediatric Empyema Thoracis cases after definite intervention– A study from tertiary care hospital of Central India

Dr Shipra Sharma; Santosh Kumar Sonkar; Dr Mayank Dewangan; Dr Narendra Prasad Narsingh; Dr. Uttam Rawate

Volume : IV, Issue : VII, July - 2015

Assessment of lung function improvement among paediatric Empyema Thoracis cases after definite intervention– A study from tertiary care hospital of Central India

Dr Shipra Sharma, Santosh Kumar Sonkar, Dr Mayank Dewangan, Dr Narendra Prasad Narsingh, Dr. Uttam Rawate

Abstract :

<p>Introduction&ndash; Empyema is never a primary disease, often it is difficult to arrive at primary focus of infection, through pleural cavity is the root of pus, the respiratory and cardiovascular system are severely affected. Pus anywhere in the body must be drained more so when it is in the pleural cavity. Collection of pus and consequent compression on the lung leads to cardiopulmonary embarrassment. When acute or chronic, early diagnosis and quick treatment must be the aim. Acute empyema is treated by immediate aspiration of pus and instillation of antibiotics into empyema cavity. This pus is sent for culture and sensitivity. Aspiration is repeated every day and patients are explained eathing, exercises to promote early expansion of lung.With the above background the present study was conducted to assess the lung function improvement among paediatric Empyema Thoracis cases after definite intervention. Material and method&ndash;The present prospective study was conducted in department of general surgery, Pt. J.N.M. Medical College and Dr BRAM hospital, Raipur (C.G.), India during study period November 2013 to October 2014.40patients according to above mentioned inclusion and exclusion criteria getting admitted during the study period was be taken under the study. Written and informed consent was taken from each patient to participate in the study. Results&ndash; In our study of 40 cases, it was found that mean age of presentation of empyema for ICD insertion was 6.6 yrs and decortications was 6 yrs. In our study of 40 cases, it was found that 22 (55%) patients were male &amp; 18(45%) were female. In our study patient who underwent thoracostomy MRC dyspnea score was: &ndash; 7 (29%) patient was in score 0, 14 (58%) patient was in sore 1 and 3(13%) patient was in score 2. Mean hospital stay was 7 days after ICD insertion and 5 days after decortication. In our study 24 patient who underwent thoracostomy having mean duration of post operative fever was 7.6 day. Conclusion&ndash; This study was prospective study of two mode of treatmenti.e., chest tube insertion and decortications. Many prospective randomized studies of decortications have shown that there is good outcome decrease in hospital stay, duration of post operative ICD insertion, post operative fever, better MRC dyspnea score and pulmonary function assessment. After decortication radiologic assessment shows clear lungs field, decrease pleural thickness, improve mediastinal shift, overcrowding of rib and scoliosis.</p>