Marked Diastolic Collapse of the Right Atrium Without Hemodynamic Compromise Caused by a Large Pleural Effusion

Wrisley, David

doi:10.1016/s0894-7317(14)80424-0

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…Some cases presented with hemodynamic compromise that resolved after pleural drainage [37][38][39], whereas others exhibited right-sided chamber collapse without gross hemodynamic disturbances [40,41]. On the contrary, Alam et al [42] described three patients with PLEF after cardiac surgery who were unable to be weaned from vasoactive drugs.…”

Section: Hemodynamic Effects Of Pleural Effusionsmentioning

confidence: 99%

Pleural effusion in the mechanically ventilated patient

Graf¹

2009

Current Opinion in Critical Care

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Section: Hemodynamic Effects Of Pleural Effusionsmentioning

confidence: 99%

Pleural effusion in the mechanically ventilated patient

Graf¹

2009

Current Opinion in Critical Care

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“…In dogs, direct compressive effects have been shown with experimental effusions when intrapleural pressure exceeds intrapericardial pressure, right ventricular diastolic collapse can occur, causing tamponade 30 . Similar effects of right ventricular diastolic collapse have been observed as incidental findings in patient case series 31–33 . Haemodynamic collapse rapidly improves following drainage in cardiac surgical patients, 34 hepatic hydrothorax and malignant effusion 35 .…”

Section: Physiological Effects Of Pleural Effusionsmentioning

confidence: 88%

“…30 Similar effects of right ventricular diastolic collapse have been observed as incidental findings in patient case series. [31][32][33] Haemodynamic collapse rapidly improves following drainage in cardiac surgical patients, 34 hepatic hydrothorax and malignant effusion. 35 It may be that many patient parameters alter the haemodynamic response to a pleural effusion.…”

Section: Effects On Haemodynamicsmentioning

confidence: 99%

Pleural effusions on the intensive care unit; Hidden morbidity with therapeutic potential

et al. 2013

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Despite 50-60% of intensive care patients demonstrating evidence of pleural effusions, there has been little emphasis placed on the role of effusions in the aetiology of weaning failure. Critical illness and mechanical ventilation lead to multiple perturbations of the normal physiological processes regulating pleural fluid homeostasis, and consequently, failure of normal pleural function occurs. Effusions can lead to deleterious effects on respiratory mechanics and gas exchange, and when extensive, may lead to haemodynamic compromise. The widespread availability of bedside ultrasound has not only facilitated earlier detection of pleural effusions but also safer fluid sampling and drainage. In the majority of patients, pleural drainage leads to improvements in lung function, with data from spontaneously breathing individuals demonstrating a consistent symptomatic improvement, while a meta-analysis in critically ill patients shows an improvement in oxygenation. The effects on respiratory mechanics are less clear, possibly reflecting heterogeneity of underlying pathology. Limited data on clinical outcome from pleural fluid drainage exist; however, it appears to be a safe procedure with a low risk of major complications. The current level of evidence would support a clinical trial to determine whether the systematic detection and drainage of pleural effusions improve clinical outcomes.

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“…It is not clear from our data whether chamber collapse in these patients result in hemodynamic compromise. Two case reports 7 , 9 described that echocardiographic signs of cardiac tamponade resolved after drainage of pleural effusion. However, these patients did not have hypotension or pulsus paradoxus.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Armstrong et al 3 confirmed the presence of right ventricular wall collapse in early diastole in patients with cardiac tamponade. Few case studies in humans, 6–9 and an animal model 10 have described cardiac chamber collapse caused by pleural effusion. The purpose of this study was to report the incidence of chamber collapse among patients with pleural effusion, in the absence of pericardial effusion, and to explore possible mechanisms of chamber collapse.…”

mentioning

confidence: 99%

The Incidence of Diastolic Right Atrial Collapse in Patients With Pleural Effusion in the Absence of Pericardial Effusion

et al. 2003

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The aim of this study was to describe the incidence of cardiac chamber collapse assessed by echocardiography and explore possible mechanisms in a clinical population of 116 patients with pleural effusion in the absence of pericardial effusion. We found that the frequency of chamber collapse was 18% in patients with pleural effusion in the absence of pericardial effusion, thus cardiac chamber collapse occurs in patients with pleural effusion.

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Marked Diastolic Collapse of the Right Atrium Without Hemodynamic Compromise Caused by a Large Pleural Effusion

Cited by 11 publications

References 7 publications

Pleural effusion in the mechanically ventilated patient

Pleural effusion in the mechanically ventilated patient

Pleural effusions on the intensive care unit; Hidden morbidity with therapeutic potential

The Incidence of Diastolic Right Atrial Collapse in Patients With Pleural Effusion in the Absence of Pericardial Effusion

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