Drainage of Large Pleural Effusions Increases Left Ventricular Preload

Hermansen, Johan Fridolf; Juhl-Olsen, Peter; Frederiksen, Christian Alcaraz; Christiansen, Lærke K.; Hørlyck, Arne; Sloth, Erik

doi:10.1053/j.jvca.2013.11.018

Cited by 13 publications

(13 citation statements)

References 25 publications

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“…Case reports of large pleural effusions causing tamponade-like pathophysiology have been published [29,[58][59][60] supported by recent studies [61,62]. Note that the positioning of the patient is relevant and pleural effusion is easier to locate when the patient is placed in the anti-Trendelenburg position (Fig.…”

Section: Pleural Effusionmentioning

confidence: 73%

Transthoracic echocardiography in the perioperative setting

Jørgensen¹,

Juhl-Olsen²,

Frederiksen

et al. 2016

Current Opinion in Anaesthesiology

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Hemodynamically significant cardiac disease or pathophysiology can be disclosed using TTE. Focused TTE is feasible for perioperative patient management and monitoring and will be an inevitable and indispensable tool for the anesthetist. Future research should focus on the outcome of perioperative TTE performed by anesthetists, using rigorous study designs and patient-centered outcomes such as mortality and morbidity.

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Section: Pleural Effusionmentioning

confidence: 73%

Transthoracic echocardiography in the perioperative setting

Jørgensen¹,

Juhl-Olsen²,

Frederiksen

et al. 2016

Current Opinion in Anaesthesiology

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“…Malgré tout, de rares cas de tamponnade cardiaque, comme pour notre patient, ont été décrits dans la littérature, majoritairement associés à un syndrome d'hyperstimulation ovarienne [6]. Il semblerait que le volume de l'épanchement joue un rôle prépondérant dans la survenue d'une altération hémodynamique [7].…”

Section: Discussionunclassified

“…Ceci conduit alors à une réduc-tion du volume d'éjection systolique. D'après les études animales et humaines, il semblerait que l'augmentation de la pression intra-pleurale pourrait être transmise à l'espace péricardique ou aux vaisseaux pulmonaires, conduisant à une altération du remplissage ventriculaire et ainsi, à une réduction du volume d'éjection systolique [7,8]. Trois mécanismes physiopathologiques pourraient en être responsables.…”

Section: Discussionunclassified

“…Ce cas, bien qu'exceptionnel, soulève la question du drainage systématique des volumineux épanche-ments pleuraux même sans retentissement respiratoire. En effet, une étude chez l'homme a montré que l'évacuation d'un épanchement pleural augmentait la précharge VG et ainsi, le volume d'éjection systolique [7]. Cet effet était d'autant plus marqué que l'épanchement pleural était important.…”

Section: Discussionunclassified

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Tamponnade cardiaque : le péricarde n’est pas toujours coupable ! À propos d’un cas

Esnault¹,

Bordes²,

Nguyen³

et al. 2014

Revue de Pneumologie Clinique

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“…In these examples, hemodynamic stability was reestablished by large volume (>1000 mL) thoracenteses. The hemodynamic impact increases with the size of the pleural effusion and this effect seems independent of the sidedness of effusion …”

Section: Pleural Effusionmentioning

confidence: 99%

When appearances deceive: Echocardiographic changes due to common chest pathology

et al. 2018

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Most indications for performing echocardiography focus on the evaluation of properties intrinsic to the heart. However, numerous extra‐cardiac conditions indirectly convey changes to the echocardiographic appearance through alterations in the governing physiology. Pulmonary embolism increases pulmonary arterial pressure if a sufficient cross‐sectional area of the pulmonary vascular bed is occluded. This may result in dilatation of the right ventricle and, in severe cases, concomitant early diastolic septal collapse into the left ventricle. Acute respiratory failure has been shown to yield a similar echocardiographic appearance in experimental conditions due to the resultant pulmonary vasoconstriction. Echocardiography in the presence of pulmonary disease can reveal underlying cardiac pathologies such as pulmonary hypertension that contribute to the clinical severity of respiratory distress. Positive pressure ventilation affects preload, afterload, and compliance of both ventricles. The echocardiographic net result cannot be uniformly anticipated, but provides information on the deciding physiology or pathophysiology. Mediastinal pathology including tumors, herniation of abdominal content, and pleural effusion can often be visualized directly with echocardiography. Mediastinal pathologies adjacent to the heart may compress the myocardium directly, thus facilitating echocardiographic and clinical signs of tamponade in the absence of pericardial effusion. In conclusion, many pathologies of extra‐cardiac origin influence the echocardiographic appearance of the heart. These changes do not reflect properties of the myocardium but may well be mistaken for it. Hence, these conditions are essential knowledge to all physicians performing echocardiography across the spectrum from advanced cardiological diagnostics to rapid point‐of‐care focused cardiac ultrasonography.

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Drainage of Large Pleural Effusions Increases Left Ventricular Preload

Cited by 13 publications

References 25 publications

Transthoracic echocardiography in the perioperative setting

Transthoracic echocardiography in the perioperative setting

Tamponnade cardiaque : le péricarde n’est pas toujours coupable ! À propos d’un cas

When appearances deceive: Echocardiographic changes due to common chest pathology

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