Disorders of the Pleura |

Features of Patients With Transudative Pleurisy Undergone Therapeutic Thoracentesis in a University Hospital FREE TO VIEW

M. Sule Akcay, MD; Zeynep Erayman, MD; Ozgur Ozen, MD
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Baskent University Hospital, Ankara, Turkey

Chest. 2014;146(4_MeetingAbstracts):441A. doi:10.1378/chest.1990002
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SESSION TITLE: Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Background and aim: According to the amount of pleural fluid is leading to dyspnea, therapeutic thoracentesis is decided by physicians. Massive pleural effusion requiring therapeutic thoracentesis is usually in exudative nature. There is not enough data in the literature on transudative effusions requiring therapeutic thoracentesis. The possible reason of this is that the main treatment of transudates is to manage the underlying diseases. In this study, we aimed to evaluate the course of these transudative effusions and often subjected to drainage procedures.

METHODS: 169 patients with therapeutic thoracentesis by the interventional radiology unit were included to this study. Patients with exudates according to the Light criteria were excluded. 60 patients with transudates were included in the study. Patients were followed after thoracentesis for two months. The results of the pleural fluid analysis, the underlying diseases, the type of treatment administered, the initial symptoms, the radiological method which is used to diagnose pleural fluid, the fluid localization, the number of thoracentesis session, the amount of liquid drainage and the complication rates were evaluated.

RESULTS: 39 patients were diagnosed with congestive heart failure, 14 were chronic renal failure, 14 were malignancy and 4 were chronic liver disease. 65% of the patients were using diuretics, 13.3% of them were in hemodialysis programme. The most common presenting symptom was dyspnea. Fluid localization of the 83.3% was unilateral and 65% was on right side. 98.3% of the patients had a chest X-ray before and after thoracentesis. Most of the patients had a medium level of pleural effusion according to chest X-ray. Therapeutic thoracentesis was performed on 38 patients (63.3%) 1, 16 patients (26.7%) 2, 3 patients (5%) 3 and 1 each patient (1.7%) 4, 5 and 6 times. Only in 1 patient had minimal pneumothorax complication and it spontaneously regressed.

CONCLUSIONS: In conclusion, the decision of interventional procedure for all pleural effusions should be considered by clinicians under multidisciplinary evaluation to avoid unnecessary intervention.

CLINICAL IMPLICATIONS: In clinical practice, therapeutic thoracentesis is frequently performed on transudative fluid. This decision should be given by pulmonary physicians. However in many centers, therapeutic thoracentesis are performed in patients transudative effusion without pulmonary consultation. In this presentation, we aim to discuss this reality.

DISCLOSURE: The following authors have nothing to disclose: M. Sule Akcay, Zeynep Erayman, Ozgur Ozen

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