Pleural Effusions

Light, Richard W.

doi:10.1016/j.mcna.2011.08.005

Cited by 206 publications

(180 citation statements)

References 59 publications

(64 reference statements)

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“…The biochemical parameters used to distinguish between pleural exudates and transudates were Light et al (24): PF/serum (S) protein ratio >0.5; PF/S LDH ratio >0.6 and PF LDH greater than two-thirds the upper limits of the laboratory's normal serum LDH (320 IU/L in our case). Patients with suspected CHF were only punctured if they had unilateral PE, asymmetric bilateral PE, chest pain or fever (25). A citology of PF (with or without pleural biopsy) was performed in those cases in which the PE not decreased with medical treatment appropiate to the established diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Predictive models of malignant transudative pleural effusions

Ferreiro¹,

Gudé²,

Toubes

et al. 2017

J. Thorac. Dis.

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Background: There are no firm recommendations when cytology should be performed in pleural transudates, since some malignant pleural effusions (MPEs) behave biochemically as transudates. The objective was to assess when would be justified to perform cytology on pleural transudates. Conclusions: The applied models have a high discriminative ability to predict when a transudative PE may be of neoplastic origin, being superior to adding an analytical variable to the clinic-radiological variables.

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Section: Methodsmentioning

confidence: 99%

Predictive models of malignant transudative pleural effusions

Ferreiro¹,

Gudé²,

Toubes

et al. 2017

J. Thorac. Dis.

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“…Thoracentesis is a commonly performed procedure for diagnostic or therapeutic purposes in up to 173,000 cases in the United States annually (1)(2)(3). Though it is generally considered safe and has a low risk during the procedure, complications have been reported (4).…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

Cho

Choi

et al. 2017

J. Thorac. Dis.

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Background: There is a lack of data regarding the incidence and associated factors of pneumothorax following thoracentesis conducted in emergency department (ED) settings. The present study aims to determine the incidence of pneumothorax following thoracentesis in ED settings and evaluate the association of specific demographics, clinical, and procedure factors with thoracentesis-related pneumothorax. Methods:We retrospectively reviewed the medical records of 3,067 thoracentesis cases in the ED of a tertiary care, university-affiliated hospital between January 2009 and December 2014. To evaluate the factors associated with the occurrence of pneumothorax following thoracentesis, matched controls were used with a case to control ratio of 1:5. Results: Of the 3,067 cases that received thoracentesis, 19 cases of pneumothorax were observed (0.62%).Patients with pneumothorax had significantly lower weight and body mass index (BMI) than those without pneumothorax (51.0 vs. 61.2 kg, 20.0 vs. 22.6; P<0.001, respectively). In the multivariate logistic regression analysis, being underweight, defined as a BMI of <18.5 [OR, 5.2 (95% CI, 1.3-21.2); P=0.021] was significantly associated with the occurrence of pneumothorax. Conclusions:The incidence of pneumothorax following thoracentesis was very low in the present study. However, clinicians should be aware of the risk of pneumothorax in underweight patients during thoracentesis. Further prospective studies are required to clarify the results of the present study.

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“…Relatív gátolt áramlás fordulhat elő, ha fokozott a nyiroktermelés, például emelkedett centrális vénás nyomású vagy portalis hypertensióban/májcirrhosisban szenvedő betegeknél [13].…”

Section: Kóroki Megoszlásunclassified

A chylothorax modern kezelésének bizonyítékalapú áttekintése

2016

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A chylothorax napjainkban rendszerint műtéti vagy baleseti szövődmény, ritkábban daganat következménye. Prospektív vagy randomizált vizsgálatok hiányában a bizonyítékalapú kezelés személyes tapasztalaton, ideálisan a retrospektív elemzések ismeretében történik. A szerzők célja a chylothorax modern kezelésének áttekintése. A PubMed adatbázist "chylothorax" kulcsszóra szűrték az elmúlt tíz év közleményei között, kiemelve az összehasonlító értéke-léseket. A módszerek és ajánlások kritikai elemzésekor a szerzők együttes 39 éves klinikai tapasztalatukra támaszkod-tak. A konzervatív kezelés sikere az etiológiától függően nagy szórást mutat (3-90%). A non-és szemi-invazív intervenciós eljárások sikerrátája 50-100% közötti. Eredménytelen konzervatív kezeléskor a sebészi kezelés, elsősorban a ductus thoracicus lekötése jelenti a standard terápiát. Ezen beavatkozások sikerességi aránya 64-100% közötti, a morbiditási/mortalitási mutató elérheti a 25%-ot. A kezelést konzervatívan kell megkezdeni, majd egy lépcsőzetes agresszivitású terápia ajánlott, amelyben a beteg állapota és a drénvolumen irányítják a döntéshozatalt. Az intervenciós radiológiai eljárások biztonságosak, sikeresek és helyet kaptak a konzervatív és műtéti megoldások mellett. Orv. Hetil., 2016, 157(2), 43-51. Kulcsszavak: chylothorax, szövődmény, mellkassebészet Review of evidence-based modern treatment for chylothoraxChylothorax is a multi-factorial complication, frequently of an operation or an accident, but rarely of a tumour. In the absence of prospective or randomised studies evidence-based treatment is normally based on personal experience, ideally in the possession of retrospective analyses using the "best practice" method. The aim of the authors was the review the up-to-date chylothorax treatments. They performed the PubMed database's "chylothorax" keyword search of the publications reported in the last ten years. They put emphasis on articles that included a comparative analysis of the various treatment options. During the critical analysis of the methods and recommendations, the authors relied on their own joint experience amounting to 39 years. The results showed that the success of the initial conservative treatment indicates a signifi cant deviation depending on the etiology (3-90%). The success rate of noninvasive or semi-invasive interventions is between 50-100%, again depending on the etiology. The standard surgical treatment following an unsuccessful conservative treatment of an operable patient includes the fi tting of a (thoracoscopic) knot to the ductus thoracicus, pleurodesis, insertion of a permanent chest drain or a pleuroperitoneal shunt. The success rate of these interventions is between 64-100%, with a morbidity index and mortality index exceeding 25%. Conservative treatment should be the fi rst step, which should then be followed by a gradually increased aggressive therapy, during which the decisions should be made according to the patient's condition and the drain volume. Interventional radiology procedures are safe, successful an...

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Pleural Effusions

Cited by 206 publications

References 59 publications

Predictive models of malignant transudative pleural effusions

Predictive models of malignant transudative pleural effusions

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

A chylothorax modern kezelésének bizonyítékalapú áttekintése

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