What does this research mean for the field?

In children with necrotizing pneumonia, the administration of alteplase is associated with an increased risk of pneumothorax, longer hospital stays, and higher costs, but not with an increased risk of bronchopleural fistula. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate treatment strategies and clinical outcomes in pediatric patients diagnosed with necrotizing pneumonia across US children's hospitals.

September 5, 2026Journal of Pediatric Intensive Care

Management and Outcomes of Pediatric Necrotizing Pneumonia in the United States

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Authors

MNManette Ness-CochinwalaRobert Wood Johnson University Hospital KKKaitlin KobaitriAnna Needs Neuroblastoma Answers PMPaul MartinezFlorida International University

Discussion

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Overview

Retrospective cohort study reveals increased odds of pneumothorax with alteplase use in pediatric necrotizing pneumonia, highlighting treatment-associated procedural risks.

Key Points

To evaluate treatment strategies and clinical outcomes in pediatric patients diagnosed with necrotizing pneumonia across US children's hospitals.
Retrospective multicenter cohort study analyzing 2,177 pediatric patients (aged 30 days to 19 years) with lung necrosis identified in the Pediatric Health Information System.
Compared outcomes between patients receiving alteplase versus those who did not using multivariable regression and propensity score matching.
Overall mortality was 3.9%, with increased odds of death associated with mechanical ventilation (OR 15.9; 95% CI, 7.1–35.8), ECMO (OR 7.5; 95% CI, 4.27–13.0), and complex chronic conditions (OR 3.9; 95% CI, 1.7–9.1).
Alteplase administration (used in 38.8% of patients) was associated with higher odds of pneumothorax on univariate analysis (OR 3.86; 95% CI, 2.99–4.98) and in propensity score matching, as well as longer stays and higher charges, but not bronchopleural fistula.
Video-assisted thoracoscopic surgery was utilized in 4.5% of patients and was also associated with increased odds of pneumothorax (OR 2.24; 95% CI, 1.4–3.6).

Cite This Study

Ness-Cochinwala et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3c76b95aff0620eaf6d https://doi.org/10.53391/2146-4618.1083

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September 5, 2026Journal of Pediatric Intensive Care

Management and Outcomes of Pediatric Necrotizing Pneumonia in the United States

View Full Paper

Ask AI

Bookmark

Authors

MNManette Ness-CochinwalaRobert Wood Johnson University Hospital KKKaitlin KobaitriAnna Needs Neuroblastoma Answers PMPaul MartinezFlorida International University

Discussion

Member takes

Overview

Retrospective cohort study reveals increased odds of pneumothorax with alteplase use in pediatric necrotizing pneumonia, highlighting treatment-associated procedural risks.

Key Points

To evaluate treatment strategies and clinical outcomes in pediatric patients diagnosed with necrotizing pneumonia across US children's hospitals.
Retrospective multicenter cohort study analyzing 2,177 pediatric patients (aged 30 days to 19 years) with lung necrosis identified in the Pediatric Health Information System.
Compared outcomes between patients receiving alteplase versus those who did not using multivariable regression and propensity score matching.
Overall mortality was 3.9%, with increased odds of death associated with mechanical ventilation (OR 15.9; 95% CI, 7.1–35.8), ECMO (OR 7.5; 95% CI, 4.27–13.0), and complex chronic conditions (OR 3.9; 95% CI, 1.7–9.1).
Alteplase administration (used in 38.8% of patients) was associated with higher odds of pneumothorax on univariate analysis (OR 3.86; 95% CI, 2.99–4.98) and in propensity score matching, as well as longer stays and higher charges, but not bronchopleural fistula.
Video-assisted thoracoscopic surgery was utilized in 4.5% of patients and was also associated with increased odds of pneumothorax (OR 2.24; 95% CI, 1.4–3.6).

Cite This Study

Ness-Cochinwala et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3c76b95aff0620eaf6d https://doi.org/10.53391/2146-4618.1083

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