Impact of Draining Significant Effusion on Gas Exchange and Lung Mechanics in Patient Under Mechanical Ventilation

Dokuz Eylul University27 enrolled

Overview

Patients with acute respiratory failure (ARF) who were receiving mechanical ventilator support, had significant pleural effusion (both transudates and exudates) and drainage plan were evaluated. Decision to drain, timing and duration of drainage were made by primary physician according to the intensive care unit (ICU) protocols.The estimated amount of effusion (mL) was calculated as the maximum pleura-lung distance (mm) x 20 and significant effusion is accepted as ≥ 800 mL according to thoracic ultrasonography (USG) performed by the intensivist. The amount of effusion drained, mechanical ventilator parameters, arterial blood gas results and hemodynamic data were recorded before, at the 1st hour and at the end of drainage up to 30 days after drainage.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Respiration, Artificial Pleural Effusion Ultrasonography

Interventions

Drainage of the pleural effusion

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients on mechanical ventilation due to acute respiratory failure * Estimated effusion \> 800 ml according to USG * Have drainage plan according to ICU protocols decided by primary physician Exclusion Criteria: * Have absolute drainage indication (empyema, hemothorax or chylothorax) * predicted duration of mechanical ventilation less than 72 hours * contraindications to drainage, * underlying disease, which prevents lung expansion (chest deformity, central atelectasis) * malignant effusions

Outcomes

Primary Outcomes

Correlation between estimated and drained effusion volume

Volume of the effusion estimated and drained was recorded (mL)

Time frame: 1- Estimated effusion volume just before the drainage (by ultrasonography calculated as described in brief summary) 2- Drained effusion volume just after the drainage is terminated up to 30 days after procedure.

Change in Lung mechanics

Dynamic Compliance (mL/cmH2O)

Time frame: 1- Dynamic Compliance just before the drainage 2- Dynamic Compliance just after the drainage is terminated up to 30 days after procedure

Change in Oxygenation

PaO2/FiO2 (fraction of inspired oxygen)

Time frame: 1- PaO2/FiO2 just before the drainage 2- PaO2/FiO2 just after the drainage is terminated up to 30 days after procedure