Data di Pubblicazione:
2006
Citazione:
THE PLEURAL EFFUSION IN ALI/ARDS PATIENTS: A CT SCAN STUDY / D. Chiumello, M. Cressoni, P. Caironi, E. Carlesso, F. Polli, F. Tallarini, S. Terragni, M. Lazzerini. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 32:suppl 1(2006), pp. S222-S222. (Intervento presentato al 19. convegno European Society of Intensive Care Medicine, Annual Congress tenutosi a Barcelona nel 2006).
Abstract:
INTRODUCTION. The pleural effusion in patients with ALI/ARDS is a quite common finding. However,
there are only few data which evaluated the presence/amount of pleural effusion and its clinical
consequences. We aimed to compute the amount of pleural effusion and the impairment of gas exchange
and the severity of lung disease.
METHODS. Patients were studied at PEEP 5, 15 and 45 cmH2O of airway pressure during an end
expiratory pause, by lung spiral CT scan (exposure 120 Kv-250 mA). Gas exchange was measured at
the two PEEP levels. The outline of the lungs and of pleural effusion were manually delineated in each
image by a physician using a dedicated software (Soft-EFilm University of Milan). Lung recruitability
was computed as the fraction of total lung weight which regains inflation from 5 to 45 cmH2O of airway
pressure. Patients were grouped according to the median value of the amount of pleural effusion.
RESULTS. 68 ALI/ARDS patients mechanically ventilated (age 55±17 yrs, BMI 25±5 Kg/m2,
PaO2/FiO2 200±77, PEEP 11.1±3.0 cmH2O, tidal volume 8.8±1.9 ml/Kg) were enrolled. The
median pleural effusion was 293 ml (range 0-1023 ml).
In table data are presented as mean ± SD.
TABLE 1.
Lower pleural effusion Higher pleural effusion
PaO2 (mmHg) 79±21 80±26
PaCO2 (mmHg) 42±9 41±8
Age (yrs) 50±18 60±15
Lung weight (gr) 1560±515 1441±496
Lung recruitability (%) 13±10 13±13
p<0.05 vs Lower Effusion
CONCLUSION. The presence of pleural effusion was not related to the impairment of gas exchange
and to the amount of lung disease. Older patients presented a higher amount of pleural effusion probably
due to a reduction of lymph drainage.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Acute Respiratory Distress Syndrome
Elenco autori:
D. Chiumello, M. Cressoni, P. Caironi, E. Carlesso, F. Polli, F. Tallarini, S. Terragni, M. Lazzerini
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