A follow-up study for pulmonary function evaluation in children with complicated parapneumonic pleural effusion

Objectives: Although children with complicated parapneumonic effusions (CPEs) clinically improve within weeks after being discharged from the hospital, it remains unclear whether the injury and subsequent repair of the damaged lung allow a full return to premorbid lung function. We investigated the pulmonary function status in children whose CPE had been treated with different modalities. Patients and Methods: We therefore enrolled forty patients with a history of CPE: (1) patients treated with systemic antibiotics and conventional chest tube therapy only (control Group 1, n = 11); (2) patients treated with systemic antibiotics, conventional chest tube therapy, and intrapleural fibrinolytic therapy (Group 2, n = 20); and (3) patients treated with surgical intervention in addition to prior medical treatment (Group 3, the surgical rescue group, n = 9). Pulmonary function tests were done when patients had been discharged at least for 1 year. We used a spirometry test for pediatric pulmonary functions. Results: The basic demographic data of the three groups were not significantly different. The forced volume vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly higher in Group 2 patients (percentage of the predicted value in FVC: 87.6% ± 8.5% versus 79.2% ± 13.4% (Group 1) vs. 77.6% ± 9.0% (Group 3)). Significantly, fewer Group 2 patients had abnormal pulmonary function (P < 0.05). Conclusions: Our data support a growing body of evidence that empyema in children may lead to reduced lung function later in life for a subset of patients.