<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312023000100035</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Correlación fisiopatológica, diagnóstica y terapéutica en el derrame pleural paraneumónico]]></article-title>
<article-title xml:lang="en"><![CDATA[Pathophysiological, diagnostic and therapeutic correlation in parapneumonic pleural effusion]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Loret de Mola Bueno]]></surname>
<given-names><![CDATA[Yanet de los Ángeles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Prince Martínez]]></surname>
<given-names><![CDATA[Ivette Alicia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández Chiu]]></surname>
<given-names><![CDATA[Luis Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sugrañes Montalván]]></surname>
<given-names><![CDATA[Arianna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muzio González]]></surname>
<given-names><![CDATA[Verena Lucila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Bernal]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pediátrico Provincial &#8220;Dr. Eduardo Agramonte Piña&#8221; Unidad de Terapia Intensiva ]]></institution>
<addr-line><![CDATA[ Camagüey]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro de Ingeniería Genética y Biotecnología (CIGB) Investigaciones Clínicas ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>95</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312023000100035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312023000100035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312023000100035&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La inflamación de la pleura desencadenada por bacterias y mediada por citocinas, aumenta la permeabilidad vascular y produce vasodilatación, lo cual genera desequilibrio entre la producción de líquido pleural y su capacidad de reabsorción por eficientes mecanismos fisiológicos. La condición anterior conduce al desarrollo de derrame pleural paraneumónico.  Objetivo: Exponer la importancia de la correlación fisiopatológica y diagnóstica con los pilares fundamentales de actuación terapéutica en el derrame pleural paraneumónico.  Métodos: Revisión en PubMed y Google Scholar de artículos publicados hasta abril de 2021 que abordaran el derrame pleural paraneumónico, su fisiopatología, elementos diagnósticos, tanto clínicos como resultados del estudio del líquido pleural, pruebas de imágenes, y estrategias terapéuticas.  Análisis y síntesis de la información:  El progreso de una infección pulmonar y la producción de una invasión de gérmenes al espacio pleural favorece la activación de mecanismos que conllevan al acúmulo de fluido, depósito de fibrina y formación de septos. Este proceso patológico se traduce en manifestaciones clínicas, cambios en los valores citoquímicos y resultados microbiológicos en el líquido pleural, que acompañados de signos radiológicos y ecográficos en el tórax, guían la aplicación oportuna de los pilares de tratamiento del derrame pleural paraneumónico.  Conclusiones:  Ante un derrame pleural paraneumónico, con tabiques o partículas en suspensión en la ecografía de tórax, hallazgo de fibrina, líquido turbio o pus en el proceder de colocación del drenaje de tórax, resulta necesario iniciar fibrinólisis intrapleural. Cuando el tratamiento con fibrinolíticos intrapleurales falla, la cirugía video-toracoscópica es el procedimiento quirúrgico de elección.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The inflammation of the pleura triggered by bacteria and mediated by cytokines, increases vascular permeability and produces vasodilation, which generates imbalance between the production of pleural fluid and its resorption capacity by efficient physiological mechanisms. The above condition leads to the development of parapneumonic pleural effusion.  Objective:  To expose the importance of the pathophysiological and diagnostic correlation with the fundamental pillars of therapeutic action in parapneumonic pleural effusion.  Methods:  Review in PubMed and Google Scholar of articles published until April 2021 that addressed parapneumonic pleural effusion, its pathophysiology, diagnostic elements, both clinical and results of the pleural fluid study, imaging tests, and therapeutic strategies.  Analysis and synthesis of information:  The progress of a lung infection and the production of an invasion of germs into the pleural space favors the activation of mechanisms that lead to the accumulation of fluid, fibrin deposition and formation of septa. This pathological process results in clinical manifestations, changes in cytochemical values and microbiological results in the pleural fluid, which accompanied by radiological and ultrasound signs in the chest, guide the timely application of the pillars of treatment of parapneumonic pleural effusion.  Conclusions:  In the event of a parapneumonic pleural effusion, with septums or particles in suspension on chest ultrasound, finding fibrin, turbid fluid or pus in the procedure of placement of the chest drain, it is necessary to initiate intrapleural fibrinolytic. When treatment with intrapleural fibrinolytics fails, video-thoracoscopic surgery is the surgical procedure of choice.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[derrame pleural paraneumónico]]></kwd>
<kwd lng="es"><![CDATA[empiema]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico]]></kwd>
<kwd lng="es"><![CDATA[fibrinólisis intrapleural]]></kwd>
<kwd lng="es"><![CDATA[algoritmo terapéutico]]></kwd>
<kwd lng="en"><![CDATA[parapneumonic pleural effusion]]></kwd>
<kwd lng="en"><![CDATA[empyema]]></kwd>
<kwd lng="en"><![CDATA[diagnosis]]></kwd>
<kwd lng="en"><![CDATA[intrapleural fibrinolysis]]></kwd>
<kwd lng="en"><![CDATA[therapeutic algorithm]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<collab>Comité de Infecciones Respiratorias de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE)</collab>
<article-title xml:lang=""><![CDATA[Consenso SLIPE sobre Neumonía Adquirida en la Comunidad]]></article-title>
<source><![CDATA[Rev Enfermedades Infecciosas Pediatr]]></source>
<year>2010</year>
<volume>24</volume>
<numero>94</numero>
<issue>94</issue>
<page-range>1-23</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brines]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedades de la pleura]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
<name>
<surname><![CDATA[Jiménez]]></surname>
<given-names><![CDATA[GF]]></given-names>
</name>
</person-group>
<source><![CDATA[Nuevo Tratado de Pediatría. 10 ed]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Barcelona ]]></publisher-loc>
<publisher-name><![CDATA[Oceano/Ergon]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Serrano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[De Lama]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Derrame pleural en el niño]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Casado Flores]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Serrano González]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Curso on -line de urgencias y tratamiento del niño grave]]></source>
<year>2017</year>
<page-range>407-15</page-range><publisher-name><![CDATA[Salud Digital Formación]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hansen]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thorax. Pleura and lungs]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Hansen]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
</person-group>
<source><![CDATA[Netter`s Clinical Anatomy]]></source>
<year>2019</year>
<edition>4th</edition>
<page-range>101-11</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosa González]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Vallejo Hernández]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[López Llerena]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rubio Puerta]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ortega Polar]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Panadero Carlavilla]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Derrame Pleural]]></source>
<year>2017</year>
<publisher-name><![CDATA[Bot Plus-farmacéuticos]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Winnie]]></surname>
<given-names><![CDATA[GB]]></given-names>
</name>
<name>
<surname><![CDATA[Vemana]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Haider]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Lossef]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pleuritis, Derrame pleural y Empiema]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Kliegman]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[StGeme III]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Blum]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Tasker]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Wilson]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
</person-group>
<source><![CDATA[Nelson. Tratado de Pediatría. 21th ed]]></source>
<year>2020</year>
<page-range>2274-8</page-range><publisher-loc><![CDATA[España ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Noya]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Moya]]></surname>
<given-names><![CDATA[GN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Derrame pleural]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Roca]]></surname>
<given-names><![CDATA[Goderich]]></given-names>
</name>
</person-group>
<source><![CDATA[Temas de Medicina Interna T I]]></source>
<year>2017</year>
<page-range>268-71</page-range><publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Putruele]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Levi]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Síndromes pleurales]]></article-title>
<collab>Argente-Álvarez</collab>
<source><![CDATA[Semiología médica. Fisiopatología, Semiotecnia y Propedéutica. 2da ed]]></source>
<year>2013</year>
<page-range>574-81</page-range><publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
<publisher-name><![CDATA[Editorial médica panamericana]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Recuero Díaz]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Valoración del derrame pleural]]></article-title>
<source><![CDATA[Med respiratoria]]></source>
<year>2017</year>
<volume>10</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>47-64</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Villena]]></surname>
<given-names><![CDATA[GV]]></given-names>
</name>
<name>
<surname><![CDATA[Cases]]></surname>
<given-names><![CDATA[VE]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[VA]]></given-names>
</name>
<name>
<surname><![CDATA[De Pablo]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Porcel]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Normativa sobre el diagnóstico y tratamiento del derrame pleural. Actualización]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2014</year>
<volume>50</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>235-49</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ferreiro]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[San José]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Valdés]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo del derrame pleural paraneumónico en adultos]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2015</year>
<volume>51</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>611-66</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública</collab>
<source><![CDATA[Consenso Nacional para el Diagnóstico y Tratamiento de la Neumonía Adquirida en la Comunidad en Pediatría. Grupo Nacional de Pediatría. Grupo Nacional de Infectología. Comisión Nacional de Infecciones Respiratorias Agudas]]></source>
<year>2013</year>
<publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Sociedad Cubana de Pediatría]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<collab>Guía de práctica clínica</collab>
<source><![CDATA[Diagnóstico y tratamiento del derrame pleural. Evidencias y recomendaciones. Actualización]]></source>
<year>2016</year>
<publisher-name><![CDATA[CENETEC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Andrés]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Asencio]]></surname>
<given-names><![CDATA[CO]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complicaciones de la neumonía adquirida en la comunidad: derrame pleural, neumonía necrotizante, absceso pulmonar, pioneumotórax]]></article-title>
<source><![CDATA[Protoc Diagn Ter Pediatr]]></source>
<year>2017</year>
<page-range>127-46</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Porcel]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[García Gil]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Urgencias en enfermedades de la pleura]]></article-title>
<source><![CDATA[Rev Clin Esp]]></source>
<year>2013</year>
<volume>213</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>242-50</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bonina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bellía]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Cancellara]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[NE]]></given-names>
</name>
<name>
<surname><![CDATA[Gutiérrez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neumonía con derrame pleural]]></article-title>
<source><![CDATA[Rev Pediátr Elizalde]]></source>
<year>2018</year>
<volume>9</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>36-41</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quesada Guillén]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Pozo Abreu]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Larrarte]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Derrames pleurales trasudado y exudado: clasificación]]></article-title>
<source><![CDATA[Rev Cubana Reumatol]]></source>
<year>2018</year>
<volume>20</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Vera]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
<name>
<surname><![CDATA[Piñel]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo del paciente con derrame pleural]]></article-title>
<source><![CDATA[Neumosur]]></source>
<year>2016</year>
<page-range>301-11</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
<name>
<surname><![CDATA[Thiagarajan]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of endothelium in thrombosis and hemostasis]]></article-title>
<source><![CDATA[Ann Rev Med]]></source>
<year>1996</year>
<volume>47</volume>
<page-range>315-31</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castellino]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recent advances in the chemistry of the fibrinolytic system]]></article-title>
<source><![CDATA[Chem Rev]]></source>
<year>1981</year>
<volume>81</volume>
<page-range>431-46</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Francis]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Marder]]></surname>
<given-names><![CDATA[VJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fibrinolytic therapy for venous thrombosis]]></article-title>
<source><![CDATA[Prog Cardiovasc Dis]]></source>
<year>1991</year>
<volume>34</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>193-204</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castellino]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Biochemistry of human plasminogen]]></article-title>
<source><![CDATA[Semin Thromb Hemost]]></source>
<year>1984</year>
<volume>10</volume>
<page-range>18-23</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Marrero]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estreptoquinasa a propósito de un agente trombolítico]]></article-title>
<source><![CDATA[Biotecnol Aplic]]></source>
<year>2005</year>
<volume>22</volume>
<page-range>182-90</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Taranto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Muiño]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
<name>
<surname><![CDATA[Gutierrez]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Di Rado]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ghiglione]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uso de fibrinolíticos en el espacio pleural en pacientes críticos como alternativa al tratamiento quirúrgico]]></article-title>
<source><![CDATA[Rev Tórax]]></source>
<year>2018</year>
<volume>32</volume>
<page-range>21-4</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Griffith]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Boal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rogers]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evolution of practice in de management of paraneumonic effusion and empyema in children]]></article-title>
<source><![CDATA[J Pediatr Surg]]></source>
<year>2018</year>
<volume>53</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>644-6</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barthwal]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intrapleural Fibrinolytic Therapy in Loculated Pleural Effusions]]></article-title>
<source><![CDATA[J Assoc Physicians India]]></source>
<year>2020</year>
<volume>68</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>32-4</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Scotta]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Marostica]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neumonía en niños]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Wilmott]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Deterding]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ratjen]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Sly]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Zar]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Bush]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Kendig´s Enfermedades Respiratorias en Niños]]></source>
<year>2019</year>
<edition>9na</edition>
<page-range>1597</page-range><publisher-loc><![CDATA[Barcelona, España ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Altmann]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Crossingham]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Wilson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intra-pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult parapneumonic effusions and empiema]]></article-title>
<source><![CDATA[Cochrane DatabaseSyst Rev]]></source>
<year>2019</year>
<numero>10</numero>
<issue>10</issue>
</nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van Loo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[van Loo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Selvadurai]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[van Asperen]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Fitzgerald]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intrapleuralurokinase versus surgical management of childhood empyema]]></article-title>
<source><![CDATA[J Paediatr Child Health]]></source>
<year>2014</year>
<volume>50</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>823-6</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zampoli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kappos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Verwey]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Mamathuba]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zar]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of fibrinolytics on the outcome of empyema in South African children]]></article-title>
<source><![CDATA[S Afr Med J]]></source>
<year>2015</year>
<volume>28</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mathew]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Soni]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mittal]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Singhi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gautam]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intrapleural streptokinase is effective and safe for children with multi-loculated empyem are gardless of the time from diseaseonset]]></article-title>
<source><![CDATA[Acta Paediatr]]></source>
<year>2018</year>
<volume>107</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2165-71</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[IC]]></given-names>
</name>
<name>
<surname><![CDATA[Ramos]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Barreiro]]></surname>
<given-names><![CDATA[PB]]></given-names>
</name>
<name>
<surname><![CDATA[Cantillo]]></surname>
<given-names><![CDATA[GH]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[SI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evolución clínica, aislamiento microbiológico y costo antimicrobiano de la neumonía complicada adquirida en la comunidad]]></article-title>
<source><![CDATA[Rev Cubana Pediatr]]></source>
<year>2017</year>
<volume>89</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
</nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García Rodríguez]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Pérez]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Morales Rivero]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez Reyes]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Benavides Márquez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Chávez Chacón]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uso de estreptoquinasa recombinante intrapleural en una mujer embarazada con empiema pleural]]></article-title>
<source><![CDATA[AMC]]></source>
<year>2018</year>
<volume>22</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>767-80</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kheir]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Thakore]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mehta]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Jantz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Parikh]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chee]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intrapleural Fibrinolytic Therapy versus Early Medical Thoracoscopy for Treatment of Pleural Infection. Randomized Controlled Clinical Trial]]></article-title>
<source><![CDATA[Ann Am Thorac Soc]]></source>
<year>2020</year>
<volume>17</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>958-64</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castelló]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Arbolay]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Loret de Mola]]></surname>
<given-names><![CDATA[PE]]></given-names>
</name>
<name>
<surname><![CDATA[Rodriguez]]></surname>
<given-names><![CDATA[AY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eficacia de la cirugía videotoracoscópica en el tratamiento del derrame pleural paraneumónico complicado en niños]]></article-title>
<source><![CDATA[AMC]]></source>
<year>2018</year>
<volume>22</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Piriz-Assa]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Trinchet-Soler]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tapia]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Laforte]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tratamiento del derrame pleural paraneumónico complicado en niños]]></article-title>
<source><![CDATA[Rev Cubana Med Int Emerg]]></source>
<year>2016</year>
<volume>15</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>42-52</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Loret de Mola Bueno]]></surname>
<given-names><![CDATA[YA]]></given-names>
</name>
<name>
<surname><![CDATA[Muzio González]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández-Bernal]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eficacia y seguridad de la estreptoquinasa recombinante en niños con derrame pleural paraneumónico]]></article-title>
<source><![CDATA[Rev Cubana Pediatr]]></source>
<year>2020</year>
<volume>92</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
