Effect of Thoracocentesis on Spirometry, ABG Values and 6 Min Walk Test in Symptomatic Patients with Moderate and Massive Pleural Effusions
Authors/Creators
- 1. Postgraduate, Department of Respiratory Medicine, SCB Medical College and Hospital, Cuttack, Odisha, India
- 2. Department of Respiratory Medicine, Government Medical College, Sundergarh, Odisha, India
Description
Introduction: Pleural effusion is characterised by abnormal accumulation of fluid in pleural space secondary to local or systemic diseases. This clinical condition causes changes in respiratory mechanics with reduction in static and dynamic lung function. Impact of thoracocentesis on various physiological parameters of respiratory system including spirometric variables, arterial blood gases, mechanical properties and respiratory muscle function. Aims and Objectives: To determine the effect of thoracocentesis on spirometry, exercise tolerance and ABG values in patients with moderate to massive pleural effusions and comparing pre and post thoracocentesis value. Material and Methods: This is a prospective observational study accepted by the Institutional Ethics Committee of this tertiary medical college & hospital. Inclusion Criteria: Symptomatic patients of > 18 years age admitted to chest and TB ward diagnosed with pleural effusions – moderate and massive by chest radiology. Exclusion Criteria: Asymptomatic, not giving consent and having mild effusions, encysted effusions, effusions with hydropneumothorax other comorbidity that causes dyspnea and exercise intolerance. Spirometry, ABG and 6MWT done before and after thoracocentesis. Results: Total of 71 patients included. Mean values of pre and post thoracocentesis FEV1 were 1.17±0.49 and 1.29±0.51 l respectively. Mean values of pre and post thoracocentesis FVC were 1.27±0.53 and 1.42±0.60 l respectively showing the improvement in both FEV1 and FVC to be statistically significant. PaO2 increased significantly 6 hrs after therapeutic aspiration. Mean values of PaO2 pre and post-thoracocentesis were 71.54±10.37 and 72.86±11.20 mmHg respectively with p value of 0.015. 6MWD also increase 6 hrs post thoracocentesis. Mean 6MWD pre and post thoracocentesis were 487±102.32m and 513±105.93m respectively. Post therapeutic aspiration 6MWD increased from 89% to 94% of predicted 6MWD of all patients with p value of 0.001 showing the improvement to be statistically significant. Conclusion: Therapeutic thoracocentesis is highly effective in providing modest improvement in FeV1, FVC and PaO2 in patients with large volume effusion and there is significant improvement in 6MWD. The benefits of fluid removal are more evident in situations of exertion, where it allows patients to go back to their daily routine activities.
Abstract (English)
Introduction: Pleural effusion is characterised by abnormal accumulation of fluid in pleural space secondary to local or systemic diseases. This clinical condition causes changes in respiratory mechanics with reduction in static and dynamic lung function. Impact of thoracocentesis on various physiological parameters of respiratory system including spirometric variables, arterial blood gases, mechanical properties and respiratory muscle function. Aims and Objectives: To determine the effect of thoracocentesis on spirometry, exercise tolerance and ABG values in patients with moderate to massive pleural effusions and comparing pre and post thoracocentesis value. Material and Methods: This is a prospective observational study accepted by the Institutional Ethics Committee of this tertiary medical college & hospital. Inclusion Criteria: Symptomatic patients of > 18 years age admitted to chest and TB ward diagnosed with pleural effusions – moderate and massive by chest radiology. Exclusion Criteria: Asymptomatic, not giving consent and having mild effusions, encysted effusions, effusions with hydropneumothorax other comorbidity that causes dyspnea and exercise intolerance. Spirometry, ABG and 6MWT done before and after thoracocentesis. Results: Total of 71 patients included. Mean values of pre and post thoracocentesis FEV1 were 1.17±0.49 and 1.29±0.51 l respectively. Mean values of pre and post thoracocentesis FVC were 1.27±0.53 and 1.42±0.60 l respectively showing the improvement in both FEV1 and FVC to be statistically significant. PaO2 increased significantly 6 hrs after therapeutic aspiration. Mean values of PaO2 pre and post-thoracocentesis were 71.54±10.37 and 72.86±11.20 mmHg respectively with p value of 0.015. 6MWD also increase 6 hrs post thoracocentesis. Mean 6MWD pre and post thoracocentesis were 487±102.32m and 513±105.93m respectively. Post therapeutic aspiration 6MWD increased from 89% to 94% of predicted 6MWD of all patients with p value of 0.001 showing the improvement to be statistically significant. Conclusion: Therapeutic thoracocentesis is highly effective in providing modest improvement in FeV1, FVC and PaO2 in patients with large volume effusion and there is significant improvement in 6MWD. The benefits of fluid removal are more evident in situations of exertion, where it allows patients to go back to their daily routine activities.
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IJPCR,Vol15,Issue8,Article41.pdf
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Additional details
Dates
- Accepted
-
2023-08-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue8,Article41.pdf
- Development Status
- Active
References
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