Pleural space elastance and changes in oxygenation after therapeutic thoracentesis in ventilated patients with heart failure and transudative pleural effusions

Respirology : Official Journal of the Asian Pacific Society of Respirology
Wei-Lin ChenShi-Chuan Chang

Abstract

Therapeutic thoracentesis (TT) is required in patients with refractory pleural effusions and impaired oxygenation. In this study, the relationship between pleural space elastance (PE) and changes in oxygenation after TT was investigated in ventilated patients with heart failure and transudative pleural effusions. Twenty-six mechanically ventilated patients with heart failure and significant transudative effusions, who were undergoing TT, were studied. The effusion was drained as completely as possible, with monitoring of pleural liquid pressure (Pliq) and chest symptoms. The volume of effusion removed, the changes in Pliq during TT, PE and arterial blood gases before and after TT were recorded. The mean volume of effusion removed was 1011.9 +/- 58.2 mL. The mean Pliq decreased from 14.5 +/- 1.0 to 0.1 +/- 1.5 cm H(2)O after TT, and the mean PE was 15.3 +/- 1.8 cm H(2)O/L. TT significantly increased the mean ratio of PaO(2)/fraction of inspired oxygen (FiO(2)) from 243.2 +/- 19.9 to 336.0 +/- 17.8 mm Hg (P < 0.0001). The changes in PaO(2)/FiO(2) ratio after TT were inversely correlated with PE (r = -0.803, P < 0.0001). The 14 patients (54%) with normal PE (<or=14.5 cm H(2)O/L) had significantly greater increases in PaO(2)/FiO(2)...Continue Reading

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Citations

Apr 14, 2012·Current Opinion in Pulmonary Medicine·Ewan C Goligher, Niall D Ferguson
Jan 20, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Peter R EastwoodToby M Maher
Feb 1, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Chi Chiu LeungStephen G Spiro
Aug 1, 2014·Annals of the American Thoracic Society·Keyvan RazaziArmand Mekontso Dessap
May 16, 2015·Current Opinion in Pulmonary Medicine·Rajesh ThomasBhajan Singh
Nov 15, 2011·Journal of Intensive Care Medicine·David M MasloveWare G Kuschner
Aug 25, 2018·The International Journal of Artificial Organs·Anna M SteckaRafał Krenke
Oct 24, 2019·Journal of Intensive Care Medicine·Marjorie BatemanFayez Kheir
Oct 28, 2019·Journal of Bronchology & Interventional Pulmonology·Søren H SkaarupGiampietro Marchetti
Aug 4, 2020·Acute Medicine & Surgery·Masako SakuraiJun Oda
Feb 16, 2018·BMC Pulmonary Medicine·Monika Zielinska-KrawczykRafal Krenke
Apr 9, 2019·Acta Cardiologica·Aleksandar LazarevicEugenio Picano

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