Effects of pleural drainage on oxygenation in critically ill patients

Abstract

Aim Pleural effusion is common among critically ill patients and associated with clinical consequences; however, the benefits of draining pleural effusion remain debatable. Thus, we aimed to investigate pleural drainage effectiveness by focusing on preprocedure patient status. Methods We retrospectively analyzed 22 patients with pleural effusion. Gas exchange, ventilator settings, vital signs, inflammatory response, and nutrition status were examined preprocedure and 24 h and 1 week postprocedure. Data were analyzed using the non‐parametric test and discriminant analysis with receiver operating characteristic curves. Results The partial arterial oxygen pressure (PaO 2 ) to fraction of inspiratory oxygen (F I O 2 ) (P/F) ratio at 24 h was higher postdrainage than predrainage (250 ± 87 versus 196 ± 84, P < 0.05); however, no significant difference between the P/F ratio predrainage and 1 week postdrainage was noted. Patients were classified into effective and ineffective groups according to a 110% increase in the P/F ratio 1 week postdrainage compared with predrainage. The predrainage P/F ratio was lower in the effective group than in the ineffective group (165 ± 91 versus 217 ± 74, P < 0.05). Discriminant analysis showed the area under the receiver operating characteristic curve was 0.72; the cut‐off value of the predrainage P/F ratio (divided into effective and ineffective groups) was 174. Conclusions Pleural drainage could be effective in patients who have lower preprocedure P/F ratios.

Transhiatal chest drainage in mediastinoscope and laparoscope-assisted esophagectomy for esophageal cancer: a retrospective study

“…Author details 1 Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan. 2 Department of Surgery, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka, Ibaraki, Japan.…”

“…Chest drainage is essential for full lung expansion in the postoperative management of esophagectomy due to the clinical consequences of pleural effusion [ 1 ]. Mediastinoscope and laparoscope-assisted radical esophagectomy for esophageal cancer is not performed through the thoracic approach [ 2 , 3 ].…”

Transhiatal Chest Drainage Reduces The Frequency of Postoperative Thoracentesis In Transmediastinal Esophagectomy For Esophageal Cancer: A Retrospective Study

“…Chest drainage is essential for full lung expansion in postoperative management of esophagectomy due to the clinical consequences of pleural effusion [1]. Transmediastinal radical esophagectomy for esophageal cancer is performed without the thoracic approach [2,3].…”