Pleural effusion in the mechanically ventilated patient

Abstract

PLEF drainage does not always improve oxygenation in MVP with acute respiratory failure. An assessment of chest wall compliance and a lung recruitment maneuver may help predict the response. Procedural complication risks should be considered when choosing the best approach.

Non-pulmonary factors strongly influence the stress index

“…Pleural effusions present an interesting challenge to PV curve interpretation, as they decouple the inflation properties of the lung and chest wall that comprise the C RS [5]. Thus, as pleural effusion builds, the chest wall expands outward, while the adjacent lung is compressed.…”

Effect of Ultrasound-Guided Thoracocentesis on Clinical and Physiological Outcomes in Mechanically Ventilated Patients

“…On the contrary, Talmor and colleagues [10] found no correlation between the drained volume and oxygenation response.…”

“…When the pleural effusion is large or chest wall compliance is reduced, effusions cause hypoxia by collapsing lung with consequent physiologic shunt [9]. Drainage of pleural effusions allowing re-expansion of collapsed lung and improvement of hypoxia, which yield variably over the subsequent 24 h and may continue for several weeks [10].…”

Stress index in presence of pleural effusion: does it have any meaning?

“…However, in ALI/ ARDS patients, due to the extreme variability of the chest wall compliance, airway pressure changes are not a good surrogate for lung compliance [13]. The presence of pleural effusion can impair the mechanical properties of the respiratory system [14,15]. Pleural effusion significantly increases the pleural volume (i.e., in normal conditions it is almost zero), which is accommodated by an increase in chest wall volume and a reduction in lung gas volume [14].…”

“…The presence of pleural effusion can impair the mechanical properties of the respiratory system [14,15]. Pleural effusion significantly increases the pleural volume (i.e., in normal conditions it is almost zero), which is accommodated by an increase in chest wall volume and a reduction in lung gas volume [14]. Normally the reduction in lung gas volume is lower than the amount of pleural volume.…”