Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis
Abstract Background Although the impact of therapeutic thoracentesis on lung function and blood gases has been evaluated in several studies, some physiological aspects of pleural fluid withdrawal remain unknown. The aim of the study was to assess the changes in pleural pressure amplitude (Pplampl) d...
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-018-0595-7 |
| _version_ | 1818840578596536320 |
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| author | Monika Zielinska-Krawczyk Elzbieta M. Grabczak Marcin Michnikowski Krzysztof Zielinski Piotr Korczynski Anna Stecka Tomasz Golczewski Rafal Krenke |
| author_facet | Monika Zielinska-Krawczyk Elzbieta M. Grabczak Marcin Michnikowski Krzysztof Zielinski Piotr Korczynski Anna Stecka Tomasz Golczewski Rafal Krenke |
| author_sort | Monika Zielinska-Krawczyk |
| collection | DOAJ |
| description | Abstract Background Although the impact of therapeutic thoracentesis on lung function and blood gases has been evaluated in several studies, some physiological aspects of pleural fluid withdrawal remain unknown. The aim of the study was to assess the changes in pleural pressure amplitude (Pplampl) during the respiratory cycle and respiratory rate (RR) in patients undergoing pleural fluid withdrawal. Methods The study included 23 patients with symptomatic pleural effusion. Baseline pleural pressure curves were registered with a digital electronic manometer. Then, the registrations were repeated after the withdrawal of consecutive portions of pleural fluid (200 ml up to 1000 ml and 100 ml above 1000 ml). In all patients the pleural pressure curves were analyzed in five points, at 0, 25%, 50%, 75% and 100% of the relative volume of pleural effusion withdrawn in particular patients. Results There were 11 and 12 patients with right sided and left sided pleural effusion, respectively (14 M, 9F, median age 68, range 46–85 years). The most common cause of pleural effusion were malignancies (20 pts., 87%). The median total volume of withdrawn pleural fluid was 1800 (IQR 1500–2400) ml. After termination of pleural fluid withdrawal Pplampl increased in 22/23 patients compared to baseline. The median Pplampl increased from 3.4 (2.4–5.9) cmH2O to 10.7 (8.1–15.6) cmH2O (p < 0.0001). Three patterns of Pplampl changes were identified. Although the patterns of RR changes were more diversified, a significant increase between RR at baseline and the last measurement point was found (p = 0.0097). Conclusions In conclusion, therapeutic thoracentesis is associated with significant changes in Pplampl during the respiratory cycle. In the vast majority of patients Pplampl increased steadily during pleural fluid withdrawal. There was also an increase in RR. The significance of these changes should be elucidated in further studies. Trial registration ClinicalTrial.gov, registration number: NCT02192138, registration date: July 1st, 2014. |
| first_indexed | 2024-12-19T04:12:25Z |
| format | Article |
| id | doaj.art-b275c4db5d094d618f166de1d53d082f |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-19T04:12:25Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-b275c4db5d094d618f166de1d53d082f2022-12-21T20:36:23ZengBMCBMC Pulmonary Medicine1471-24662018-02-011811910.1186/s12890-018-0595-7Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesisMonika Zielinska-Krawczyk0Elzbieta M. Grabczak1Marcin Michnikowski2Krzysztof Zielinski3Piotr Korczynski4Anna Stecka5Tomasz Golczewski6Rafal Krenke7Department of Internal Medicine, Pulmonary Diseases & Allergy, Medical University of WarsawDepartment of Internal Medicine, Pulmonary Diseases & Allergy, Medical University of WarsawNalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesNalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesDepartment of Internal Medicine, Pulmonary Diseases & Allergy, Medical University of WarsawNalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesNalęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesDepartment of Internal Medicine, Pulmonary Diseases & Allergy, Medical University of WarsawAbstract Background Although the impact of therapeutic thoracentesis on lung function and blood gases has been evaluated in several studies, some physiological aspects of pleural fluid withdrawal remain unknown. The aim of the study was to assess the changes in pleural pressure amplitude (Pplampl) during the respiratory cycle and respiratory rate (RR) in patients undergoing pleural fluid withdrawal. Methods The study included 23 patients with symptomatic pleural effusion. Baseline pleural pressure curves were registered with a digital electronic manometer. Then, the registrations were repeated after the withdrawal of consecutive portions of pleural fluid (200 ml up to 1000 ml and 100 ml above 1000 ml). In all patients the pleural pressure curves were analyzed in five points, at 0, 25%, 50%, 75% and 100% of the relative volume of pleural effusion withdrawn in particular patients. Results There were 11 and 12 patients with right sided and left sided pleural effusion, respectively (14 M, 9F, median age 68, range 46–85 years). The most common cause of pleural effusion were malignancies (20 pts., 87%). The median total volume of withdrawn pleural fluid was 1800 (IQR 1500–2400) ml. After termination of pleural fluid withdrawal Pplampl increased in 22/23 patients compared to baseline. The median Pplampl increased from 3.4 (2.4–5.9) cmH2O to 10.7 (8.1–15.6) cmH2O (p < 0.0001). Three patterns of Pplampl changes were identified. Although the patterns of RR changes were more diversified, a significant increase between RR at baseline and the last measurement point was found (p = 0.0097). Conclusions In conclusion, therapeutic thoracentesis is associated with significant changes in Pplampl during the respiratory cycle. In the vast majority of patients Pplampl increased steadily during pleural fluid withdrawal. There was also an increase in RR. The significance of these changes should be elucidated in further studies. Trial registration ClinicalTrial.gov, registration number: NCT02192138, registration date: July 1st, 2014.http://link.springer.com/article/10.1186/s12890-018-0595-7Pleural effusionPleural fluidPleural pressureThoracentesisPleural manometryPleural pathophysiology |
| spellingShingle | Monika Zielinska-Krawczyk Elzbieta M. Grabczak Marcin Michnikowski Krzysztof Zielinski Piotr Korczynski Anna Stecka Tomasz Golczewski Rafal Krenke Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis BMC Pulmonary Medicine Pleural effusion Pleural fluid Pleural pressure Thoracentesis Pleural manometry Pleural pathophysiology |
| title | Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| title_full | Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| title_fullStr | Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| title_full_unstemmed | Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| title_short | Patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| title_sort | patterns of pleural pressure amplitude and respiratory rate changes during therapeutic thoracentesis |
| topic | Pleural effusion Pleural fluid Pleural pressure Thoracentesis Pleural manometry Pleural pathophysiology |
| url | http://link.springer.com/article/10.1186/s12890-018-0595-7 |
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