Chest
Clinical Investigations: The PleuraChanges in Pulmonary Mechanics and Gas Exchange After Thoracentesis on Patients With Inversion of a Hemidiaphragm Secondary to Large Pleural Effusion
Section snippets
Materials and Methods
From February 1990 to March 1993, patients in the medical ward with dyspnea and large pleural effusion documented by chest radiograph were considered for chest sonography. Pleural effusion was classified as large degree when there was obliteration of more than half of the hemidiaphragm. Only patients who had inversion of a hemidiaphragm proved by chest sonography (Fig 1, top) and could cooperate satisfactorily for pulmonary function test and artery blood gas were included. At the time of
Results
A total of 21 patients (13 men and 8 women; mean age, 53 years; range, 26 to 74 years) completed the pulmonary function test and arterial blood gas procedures before and 24 h after thoracentesis. The underlying diseases were as follows: tuberculous pleurisy (five cases); liver cirrhosis (five); cardiac failure (four); bronchogenic carcinoma (three); bacterial pneumonia (two); metastatic carcinoma (one); and uremia (one). The reasons for stopping the thoracentesis were as follows: no more fluid
Discussion
As in previous studies, we had shown that pleural effusion was associated with restrictive ventilatory impairment and hypoxemia. In our patients, the increase in FVC and in FEV1 averaged 317 and 234 mL, respectively, contrasting with the average of 1,610 mL of fluid aspirated from the pleural space. There was no significant change in FEV1/FVC since pleural effusion was not associated with obstructive ventilatory impairment. Although the increase of PaO2 observed after thoracentesis was
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