Pleural effusion
Most of the children benefited from an evacuation of the pleural
effusion (89/97, 91.8%): 21 patients (21.6%) were treated with needle
thoracocentesis only, while a chest tube was inserted in 68 children
(70.1%) (Table 2). Chest tube insertion and intrapleural fibrinolysis
occurred less frequently in children about to receive corticosteroids
(chest tube 61.8% versus 81.0%, p=0.041; intrapleural
fibrinolysis 25.5% versus 42.9%, p=0.07). The duration of chest
drainage did not differ between children with and without
corticosteroids (median (IQR) 5 (3-8.25) versus 5 (3-6),
p=0.184). The total volume evacuated through the chest tube tended to be
higher for children without corticosteroids (median (IQR) 480 (300-805)
mL versus 390 (137-579) mL), this discrepancy almost reaching the
statistical significance threshold (p=0.07).
Biochemical analyses of the pleural effusion were inconstant and their
results did not differ between children about to receive corticosteroids
or not: proteins were measured in 79/89 samples (88.8%) (median (IQR)
45 (39.8-48.7) g/L for the whole cohort), LDH in 64 (71.9%) (median
(IQR) 3124 (879-9367)U/L), glucose in 57 (64%) (median (IQR) 0.22
(0.01-0.67)g/L), amylase in 15 (16.9%) and pH in only 8 samples (9%).
Cytology was more frequently analyzed: the leucocyte and the red blood
cell counts were requested in 78 (87.6%) and in 73 (82%) samples
respectively and they did not differ between children with and without
corticosteroids (median (IQR) 5200 (1000-17800) red blood cells /mm3 and
6800 (1500-21100) white blood cells /mm3 for the whole cohort).