Effect of continuous positive airway pressure on fluid absorption among patients with pleural effusion due to tuberculosis

Abstract

Background: Tuberculosis (TB) remains as an important public health problem worldwide. The most common type is pulmonary TB, and the most prevalent form of extra-pulmonary disease among HIV-negative patients is pleural disease. Objective: The objective of the present study was to determine the effect of continuous positive airway pressure (CPAP) on fluid absorption among patients with pleural effusion due to TB. Methods: Twenty patients were randomized into two groups. The interventional group (n=10) received CPAP three times a week during the initial four weeks of anti-TB treatment, and the control group (n=10) received anti-TB drugs only. The primary endpoint was the volume of pleural fluid after four weeks of treatment. Both groups were submitted to thoracic computed tomography using threedimensional image reconstruction. The Mann-Whitney test for independent samples and the Wilcoxon paired samples test were used for statistical analysis. The normal distribution samples were analyzed using the unpaired t test. Results: The reduction of pleural effusion volume was significantly greater in the intervention group (83.5%±SD 3.6) than in the control group (36.9%±SD 2.9; p<0.001), and the final dyspnea index was lower in the Intervention group than in the control group (p=0.002). Conclusion: Our findings indicate that CPAP during the first month of TB treatment accelerates the absorption of pleural effusion, however, additional studies are needed to confirm these findings and evaluate the impact of CPAP on pleural sequelae after the end of anti-TB treatment.Article registered in the Clinical Trials under the number NCT00560521.Key words: physical therapy; pleural effusion; continuous positive airway pressure; pleural tuberculosis. ResumoContextualização: A tuberculose (TB) permanece como um importante problema de saúde pública no mundo. A forma mais comum de apresentação é a pulmonar e, em pacientes soronegativos, a forma de doença extrapulmonar mais prevalente é a pleural. Objetivo: Palavras-chave: fisioterapia; derrame pleural; pressão positiva contínua em vias aéreas; tuberculose pleural.

Positive pressure–assisted pleural aspiration: A case report of a novel procedure and a review of literature

“…The study demonstrated a statistically significant reduction in the pleural effusions after 4 weeks, in patients who received CPAP. 30 Therefore, there might be a place for positive pressure ventilation in the prevention of re-accumulation of pleural effusions after therapeutic thoracocentesis.…”

Impact of Continuous Positive Airway Pressure (CPAP) Masks on Arterial Blood Gas Parameters and Pulmonary Side Effects after Open-heart Surgery

“…Our findings revealed a significant difference in the incidence of pleural effusion between the test and control groups and the incidence rate was lower among the patients of the control group. Results of the study completed by Oliveira et al demonstrated that CPAP mask usage led to the diminished pleural effusion in tuberculosis patients (24). Furthermore, Marti et al reported that CPAP imposed a positive effect in individuals with heart failure due to pleural effusion (16).…”