Consecuencias del derrame pleural

Ruiz, Eduardo Montero; Ahijado, C. Hernandez; Sanchez, F. Garciia; Alvarez, Josefina

doi:10.4321/s0212-71992006000800010

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Indeed, almost in 58% (168/293) of examinations, diaphragmatic inversion or paradoxical movement of the hemi-diaphragm was detected during inspiration, and full recovery was observed after pleural fluid evacuation. Although diaphragmatic paradoxical movement has already been reported [ 13 , 45 ], this study is the first to describe this reversible phenomenon in a considerable number of malignant effusions.…”

Section: Discussionmentioning

confidence: 80%

Thoracic ultrasound use in hospitalized and ambulatory adult patients: a quantitative picture

Xirouchaki,

Bolaki,

Psarologakis

et al. 2024

Ultrasound J

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Introduction and objectives Thoracic ultrasound (TUS) has been established as a powerful diagnostic and monitoring tool in the Intensive Care Unit (ICU). However, studies outside the critical care setting are scarce. The aim of this study was to investigate the value of TUS for hospitalized or ambulatory community patients. Materials and methods This was a retrospective study conducted from 2016 to 2020 in the TUS clinic at Heraklion University Hospital. TUS examination was performed using a standard ultrasound machine (EUB HITACHI 8500), and a high-frequency microconvex probe (5–8 MHz). Patients had been referred by their primary physician to address a range of different questions. The various respiratory system entities were characterised according to internationally established criteria. Results 762 TUS studies were performed on 526 patients due to underlying malignancy (n = 376), unexplained symptoms/signs (n = 53), pregnancy related issues (n = 42), evaluation of abnormal findings in X-ray (n = 165), recent surgery/trauma (n = 23), recent onset respiratory failure (n = 12), acute respiratory infection (n = 66) and underlying non-malignant disease (n = 25). Pleural effusion was the commonest pathologic entity (n = 610), followed by consolidation (n = 269), diaphragmatic dysfunction/paradox (n = 174) and interstitial syndrome (n = 53). Discrepancies between chest X-ray and ultrasonographic findings were demonstrated in 96 cases. The TUS findings guided invasive therapeutic management in 448 cases and non-invasive management in 43 cases, while follow-up monitoring was decided in 271 cases. Conclusions This study showed that TUS can identify the most common respiratory pathologic entities encountered in hospitalized and community ambulatory patients, and is especially useful in guiding the decision making process in a diverse group of patients.

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Section: Discussionmentioning

confidence: 80%

Thoracic ultrasound use in hospitalized and ambulatory adult patients: a quantitative picture

Xirouchaki,

Bolaki,

Psarologakis

et al. 2024

Ultrasound J

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“…Large pleural effusions can alter respiratory mechanics and lead to abnormal gas exchange, reduction in diaphragmatic function or pleural irritation. Animal models have been used to study the effects of varying pleural effusion volumes and have shown that increased pleural effusion volume is associated with decreased PaO2, increased intrapulmonary shunts and a significant decrease in left ventricular preload [ 20 – 22 ]. These have been verified in human patients.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in hospitalized patients with nonmalignant pleural effusions: a retrospective cohort study

Wang,

Niu,

Chen

et al. 2024

BMC Nephrol

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Background Nonmalignant pleural effusion (NMPE) is common and remains a definite health care problem. Pleural effusion was supposed to be a risk factor for acute kidney injury (AKI). Incidence of AKI in NMPE patients and whether there is correlation between the size of effusions and AKI is unknown. Objective To assess the incidence of AKI in NMPE inpatients and its association with effusion size. Study design and method We conducted a retrospective cohort study of inpatients admitted to the Chinese PLA General Hospital with pleural effusion from 2018-2021. All patients with pleural effusions confirmed by chest radiography (CT or X-ray) were included, excluding patients with diagnosis of malignancy, chronic dialysis, end-stage renal disease (ESRD), community-acquired AKI, hospital-acquired AKI before chest radiography, and fewer than two serum creatinine tests during hospitalization. Multivariate logistic regression and LASSO logistic regression models were used to identify risk factors associated with AKI. Subgroup analyses and interaction tests for effusion volume were performed adjusted for the variables selected by LASSO. Causal mediation analysis was used to estimate the mediating effect of heart failure, pneumonia, and eGFR < 60 ml/min/1.73m2 on AKI through effusion volume. Results NMPE was present in 7.8% of internal medicine inpatients. Of the 3047 patients included, 360 (11.8%) developed AKI during hospitalization. After adjustment by covariates selected by LASSO, moderate and large effusions increased the risk of AKI compared with small effusions (moderate: OR 1.47, 95%CI 1.11-1.94 p = 0.006; large: OR 1.86, 95%CI 1.05-3.20 p = 0.028). No significant modification effect was observed among age, gender, diabetes, bilateral effusions, and eGFR. Volume of effusions mediated 6.8% (p = 0.005), 4.0% (p = 0.046) and 4.6% (p < 0.001) of the effect of heart failure, pneumonia and low eGFR on the development of AKI respectively. Conclusion The incidence of AKI is high among NMPE patients. Moderate and large effusion volume is independently associated with AKI compared to small size. The effusion size acts as a mediator in heart failure, pneumonia, and eGFR.

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Derrame Pleural Maligno, a Propósito De Un Caso

Canedo¹,

Rimaza²

2016

Rev. Inv. Inf. Sal.

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El derrame pleural se define como la acumulación patológica de líquido en el espacio situado entre las dos pleuras. El derrame pleural maligno es aquel que ocurre en el contexto de una neoplasia maligna, pudiendo originarse como consecuencia directa de dicho proceso o relacionarse indirectamente, el cual se conoce como derrame paraneoplásico. La presencia de derrame pleural maligno conlleva un mal pronóstico, ya que representa un estadio tumoral avanzado. La disnea progresiva es el síntoma más común en pacientes con derrame pleural maligno seguido por la tos y el dolor de pecho. El objetivo del tratamiento es paliativo, procedimientos locales como la pleurodesis para aliviar la disnea y mejorar la calidad de vida buscan evitar la toracentesis repetida en pacientes que no responden al tratamiento sistémico.

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Consecuencias del derrame pleural

Cited by 3 publications

References 23 publications

Thoracic ultrasound use in hospitalized and ambulatory adult patients: a quantitative picture

Thoracic ultrasound use in hospitalized and ambulatory adult patients: a quantitative picture

Acute kidney injury in hospitalized patients with nonmalignant pleural effusions: a retrospective cohort study

Derrame Pleural Maligno, a Propósito De Un Caso

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