Sustained effects of thoracocentesis on oxygenation in mechanically ventilated patients

Respirology : Official Journal of the Asian Pacific Society of Respirology
Andrew P WaldenJonathon Salmon

Abstract

No consensus exists as to the benefit of pleural drainage in mechanically ventilated patients with conflicting data concerning the effects on gas exchange. We determined the effects on gas exchange over a 48-hour period of draining, by thoracocentesis, large volume pleural effusions. A total of 15 thoracocenteses were performed in 10 mechanically ventilated patients with ultrasound evidence of pleural effusions predicted to be greater than 800 mL in volume. Gas exchange, mixed expired CO2, dynamic lung compliance, ventilator settings before procedure and at 30 min, 4, 8, 24 and 48 h were determined. Data were analysed using paired t-tests and repeated-measure anova. Following thoracocentesis there was a 40% increase in the PaO(2) from 82.0 +/- 10.6 mm Hg to 115.2 +/- 31.1 mm Hg (P < 0.05) with a 34% increase in the P:F ratio from 168.9 +/- 55.9 mm Hg to 237.8 +/- 72.6 mm Hg (P < 0.05). These effects were maintained for a period of 48 h. There was a correlation between the amount of fluid drained and the effects on oxygenation with an increase in the PaO(2) of 4 mm Hg for each 100 mL of pleural fluid drained. A-a gradients continued to improve over the course of the study together with a reduction in the dead space fraction and ...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
Oct 9, 2012·Respirology : Official Journal of the Asian Pacific Society of Respirology·Andrew P WaldenMatthew P Wise
Aug 1, 2014·Annals of the American Thoracic Society·Keyvan RazaziArmand Mekontso Dessap
Jun 27, 2015·Academic Radiology·David ChiaoJuan M Olazagasti
Jan 13, 2017·European Journal of Anaesthesiology·Kristian B WemmelundPeter Juhl-Olsen
Nov 15, 2011·Journal of Intensive Care Medicine·David M MasloveWare G Kuschner
Oct 24, 2019·Journal of Intensive Care Medicine·Marjorie BatemanFayez Kheir
Apr 27, 2017·Postgraduate Medical Journal·Stylianos A MichaelidesNikolaos Koulouris
Aug 4, 2020·Acute Medicine & Surgery·Masako SakuraiJun Oda
Jan 7, 2017·Postgraduate Medical Journal·Stylianos A MichaelidesKonstantinos A Charalabopoulos
Jan 15, 2021·Journal of Bronchology & Interventional Pulmonology·Trevor M TaylorSamira Shojaee
Aug 10, 2021·Advances in Medical Sciences·Dariusz MaciejewskiŁukasz J Krzych

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