Disorders of the Pleura |

Characteristics Trapped Lung FREE TO VIEW

Rahul Khosla, MD; Robert Maximos, MD
Author and Funding Information

Veterans Affairs Medical Center, Washington DC, MD

Chest. 2013;144(4_MeetingAbstracts):509A. doi:10.1378/chest.1705153
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SESSION TITLE: Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Pleural effusions are common, making thoracentesis one of the most commonly performed medical procedures. Trapped lung, represents the sequel of prior pleural inflammation, resulting in visceral pleural scarring or thickening. We examined the characteristics of patients with trapped lung.

METHODS: 128 pts underwent thoracentesis at the Veterans Affairs Medical Center, Washington DC. Pleural pressures were measured using an electronic pressure transducer and mean pleural pressures were recorded. Patients were monitored for symptoms during the procedure. The procedure was stopped when no more fluid was aspirated or symptoms developed. Symptoms such as chest discomfort, dyspnea or intractable cough prompted termination of the procedure. The pleural fluid, pleural manometry, and radiological data were collected from the patient’s charts. Patients were identified as having normal, trapped or entrapped lungs.

RESULTS: Ninteen patients were identified as having trapped lung. The mean fluid volume removed was 0.514 liters. The mean elastance was 226.3 cmH2O/L. Seventeen of the nineteen patients, symptoms developed pain, discomfort or both with fluid removal. There were three transudative and sixteen exudative effusions. Fourteen patients had thickened pleura on CT-scan imaging. The pleural fluid yielded a diagnosis in ten of the nineteen thoracentesis. Lung cancer was diagnosed in seven patients, two patients had empyema and one patient was diagnosed with a hemothorax.

CONCLUSIONS: In our study, trapped lung was associated with a high pleural elastance, exudative fluid, pleural thickening, and pain, discomfort or both these symptoms with fluid drainage

CLINICAL IMPLICATIONS: Recognition of trapped lung based on fluid analysis, clinical symptoms and radiological findings.

DISCLOSURE: The following authors have nothing to disclose: Rahul Khosla, Robert Maximos

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