# Management of pediatric pleural empyema: a national survey of pediatric surgeons in Brazil

## TL;DR

This study explores how Brazilian pediatric surgeons treat children with pneumonia-related pleural effusion, focusing on treatment preferences and regional differences.

## Contribution

The study provides insights into the management practices of pediatric pleural empyema among Brazilian surgeons, highlighting regional and procedural variations.

## Key findings

- Most respondents use chest drainage plus fibrinolysis for fibrinopurulent pleural effusion.
- Surgeons in the Northeast region prefer video-assisted thoracic surgery over chest drainage plus fibrinolysis.
- Treatment preferences vary with drain size based on the chosen procedure.

## Abstract

To identify how pediatric surgeons manage children with pneumonia and parapneumonic pleural effusion in Brazil.

An online cross-sectional survey with 27 questions was applied to pediatric surgeons in Brazil through the Brazilian Association of Pediatric Surgery. The questionnaire had questions about type of treatment, exams, hospital structure, and epidemiological data.

A total of 131 respondents completed the questionnaire. The mean age of respondents was 44 ± 11 years, and more than half (51%) had been practicing pediatric surgery for more than 10 years. The majority of respondents (33.6%) reported performing chest drainage and fibrinolysis when facing a case of fibrinopurulent parapneumonic pleural effusion. A preference for video-assisted thoracic surgery instead of chest drainage plus fibrinolysis was noted only in the Northeast region.

Chest drainage plus fibrinolysis was the treatment adopted by most of the respondents in this Brazilian sample. There was a preference for large drains; in contrast, smaller drains were preferred by those who perform chest drainage plus fibrinolysis. Respondents would rather change treatment when facing treatment failure or in critically ill children.