<?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>S0034-75312020000300018</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Guía de práctica clínica en derrame pleural paraneumónico y empiema pleural]]></article-title>
<article-title xml:lang="en"><![CDATA[Guide of clinical practice on parapneumonic pleural efussion and pleural empyema]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabrera Reyes]]></surname>
<given-names><![CDATA[Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santana González-Chávez]]></surname>
<given-names><![CDATA[Abel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santana Santana]]></surname>
<given-names><![CDATA[José Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abad Cerulia]]></surname>
<given-names><![CDATA[Crisanto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caraballoso García]]></surname>
<given-names><![CDATA[Víctor Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Núñez]]></surname>
<given-names><![CDATA[Blanca Rosa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pediátrico Docente &#8220;Eliseo Noel Caamaño&#8221; Servicio Cirugía Pediátrica ]]></institution>
<addr-line><![CDATA[Matanzas ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Provincial Docente &#8220;Dr. Antonio Luaces Iraola&#8221; Servicio Cirugía Pediátrica ]]></institution>
<addr-line><![CDATA[Ciego de Ávila ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2020</year>
</pub-date>
<volume>92</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312020000300018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312020000300018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312020000300018&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La acumulación de fluido purulento o la presencia de bacterias en la tinción de Gram en el líquido pleural se define como empiema, se puede desarrollar entre 2- 12 % de los niños con neumonía, por lo general bacteriana. Evoluciona en tres fases, la exudativa, fibrinopurulenta y organizada. El cuadro clínico está dado por manifestaciones respiratorias con fiebre persistente y malestar general. Los estudios radiológicos son importantes para el diagnóstico y es el ultrasonido pleural la modalidad de imagen preferida pues confirma la presencia y volumen de fluido pleural, así como la existencia de septos o tabiques. El tratamiento se basa en antibioticoterapia y drenaje a través de una pleurostomía; si hay presencia de tabiques, esfacelos o el estudio bioquímico del líquido pleural informa pH /7; glucosa /2,2 mmol/L; LDH/ 1000 UI, se comienza con estreptoquinasa intrapleural. El tratamiento quirúrgico se indica si hay deterioro clínico y radiológico después de concluir el uso de fibrinolíticos, persistencia de sepsis asociada a colección pleural a pesar del drenaje, coraza de fibrina que impide la reexpansión pulmonar y fístula broncopleural con neumotórax. La mortalidad es baja.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT The accumulation of purulent fluids or the presence of bacteria in the Gram´s stain in the pleural liquid is defined as empyema. It can develop in the 2 to 12% of children with pneumonia, generally the bacterial one. It evolves in three phases: exudative, fibrinopurulent and organized. The clinical picture is a consequence of respiratory manifestations with persistent fever and general discomfort. The radiology studies are important for the diagnosis and the pleural ultrasound is the preferred imaging modality because it confirms the presence and volume of the pleural fluid, as well as the existence of septa. The treatment is based in the use of antibiotic therapy and the drainage through a pleurostomy; if there is presence of septa, slough or the biochemical study of the pleural liquid informs of pH/7, glucose /2.2 mmol/L, LDH / 1000 UI, so it is started the use of intrapleural streptokinase. The surgical treatment is indicated if there is a clinical and radiological worsening after finishing the use of fibrinolytics, persistence of sepsis associated to pleural collection in spite of the drainage, fibrin shell that hampers pulmonar reexpanding; and bronchopleural fistula with pneumothorax.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[empiema]]></kwd>
<kwd lng="es"><![CDATA[derrame pleural paraneumónico]]></kwd>
<kwd lng="es"><![CDATA[terapia fibrinolítica]]></kwd>
<kwd lng="es"><![CDATA[tratamiento quirúrgico]]></kwd>
<kwd lng="en"><![CDATA[empyema]]></kwd>
<kwd lng="en"><![CDATA[parapneumonic pleural efussion]]></kwd>
<kwd lng="en"><![CDATA[fibrinolytic therapy]]></kwd>
<kwd lng="en"><![CDATA[surgical treatment]]></kwd>
</kwd-group>
</article-meta>
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