PREDICTIVE FACTORS, MICROBIOLOGY, AND TREATMENT OUTCOMES OF PEDIATRIC PLEURAL EMPYEMA

Pediatric pleural empyema has increased substantially over the years and was a common issue in the pediatric intensive care unit (PICU), leading to prolonged hospital stays and rising mortality rates. However, this complex condition exhibits heterogeneous data regarding prognostic factors associated with severe outcomes. Objectives: This study aims to investigate microbiological findings, treatment outcomes and predictive factors related to pleural empyema in the PICU. Participants and method: A total of 70 children (33 boys and 37 girls) were admitted to Vietnam National Children's Hospital (VNCH) from January 2021 to October 2023. Results: The median age was 8 months (range 2–21), and about 17 patients (24.3) had comorbidities. The median PICU length of stay was 20.5 days [16-28]. Septic shock occurred in 61.4% of patients, and the overall mortality rate was 32.9% (23/70). Additionally, extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) were required in 8.6% and 17.1% of cases, respectively. We observed independent factors related to mortality outcome, including only the internal treatment and negative blood or fluid culture results with Staphylococcus aureus had a higher risk of death of 3.99 (p < 0.05, 95% CI: 1.004 – 15.84) and 5.64 (p < 0.05, 95% CI: 1.10 – 29.03). In conclusion: Despite the combination of medical and surgical treatments, pleural empyema remains associated with high mortality and prolonged hospital stays.