The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion
BACKGROUND:Both elevated pleural elastance (E-PEL) and radiographic evidence of incomplete lung expansion following thoracentesis have been used to exclude patients with a malignant pleural effusion (MPE) from undergoing pleurodesis. This article reports on a cohort of patients with MPE in whom comp...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
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Elsevier
2019
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| _version_ | 1797071957937618944 |
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| author | Chopra, A Judson, M Doelken, P Maldonado, F Rahman, N Huggins, J |
| author_facet | Chopra, A Judson, M Doelken, P Maldonado, F Rahman, N Huggins, J |
| author_sort | Chopra, A |
| collection | OXFORD |
| description | BACKGROUND:Both elevated pleural elastance (E-PEL) and radiographic evidence of incomplete lung expansion following thoracentesis have been used to exclude patients with a malignant pleural effusion (MPE) from undergoing pleurodesis. This article reports on a cohort of patients with MPE in whom complete drainage was attempted with pleural manometry to determine the frequency of E-PEL and its relation with postthoracentesis radiographic findings. METHODS:Seventy consecutive patients with MPE who underwent therapeutic pleural drainage with pleural manometry were identified. The pressure/volume curves were constructed and analyzed to determine the frequency of E-PEL and the relation of PEL to the postthoracentesis chest radiographic findings. RESULTS:E-PEL and incomplete lung expansion were identified in 36 of 70 (51.4%) and 38 of 70 (54%) patients, respectively. Patients with normal PEL had an OR of 6.3 of having complete lung expansion compared with those with E-PEL (P = .0006). However, 20 of 70 (29%) patients exhibited discordance between postprocedural chest radiographic findings and the pleural manometry results. Among patients who achieved complete lung expansion on the postdrainage chest radiograph, 9 of 32 (28%) had an E-PEL. In addition, PEL was normal in 11 of 38 (34%) patients who had incomplete lung expansion as detected according to the postthoracentesis chest radiograph. CONCLUSIONS:E-PEL and incomplete lung expansion postthoracentesis are frequently observed in patients with MPE. Nearly one-third of the cohort exhibited discordance between the postprocedural chest radiographic findings and pleural manometry results. These findings suggest that a prospective randomized trial should be performed to compare both modalities (chest radiograph and pleural manometry) in predicting pleurodesis outcome. |
| first_indexed | 2024-03-06T23:00:39Z |
| format | Journal article |
| id | oxford-uuid:61fcc160-2020-455e-a0da-0e43bc2e60e5 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:00:39Z |
| publishDate | 2019 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:61fcc160-2020-455e-a0da-0e43bc2e60e52022-03-26T18:03:27ZThe relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:61fcc160-2020-455e-a0da-0e43bc2e60e5EnglishSymplectic Elements at OxfordElsevier2019Chopra, AJudson, MDoelken, PMaldonado, FRahman, NHuggins, JBACKGROUND:Both elevated pleural elastance (E-PEL) and radiographic evidence of incomplete lung expansion following thoracentesis have been used to exclude patients with a malignant pleural effusion (MPE) from undergoing pleurodesis. This article reports on a cohort of patients with MPE in whom complete drainage was attempted with pleural manometry to determine the frequency of E-PEL and its relation with postthoracentesis radiographic findings. METHODS:Seventy consecutive patients with MPE who underwent therapeutic pleural drainage with pleural manometry were identified. The pressure/volume curves were constructed and analyzed to determine the frequency of E-PEL and the relation of PEL to the postthoracentesis chest radiographic findings. RESULTS:E-PEL and incomplete lung expansion were identified in 36 of 70 (51.4%) and 38 of 70 (54%) patients, respectively. Patients with normal PEL had an OR of 6.3 of having complete lung expansion compared with those with E-PEL (P = .0006). However, 20 of 70 (29%) patients exhibited discordance between postprocedural chest radiographic findings and the pleural manometry results. Among patients who achieved complete lung expansion on the postdrainage chest radiograph, 9 of 32 (28%) had an E-PEL. In addition, PEL was normal in 11 of 38 (34%) patients who had incomplete lung expansion as detected according to the postthoracentesis chest radiograph. CONCLUSIONS:E-PEL and incomplete lung expansion postthoracentesis are frequently observed in patients with MPE. Nearly one-third of the cohort exhibited discordance between the postprocedural chest radiographic findings and pleural manometry results. These findings suggest that a prospective randomized trial should be performed to compare both modalities (chest radiograph and pleural manometry) in predicting pleurodesis outcome. |
| spellingShingle | Chopra, A Judson, M Doelken, P Maldonado, F Rahman, N Huggins, J The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title | The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title_full | The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title_fullStr | The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title_full_unstemmed | The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title_short | The relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
| title_sort | relationship of pleural manometry with postthoracentesis chest radiographic findings in malignant pleural effusion |
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