Assessment of pleural effusion quantity, assistance for quality, and management by clinical examination, sonography, and laboratory parameters in a super specialty hospital

Abstract

Introduction: This study is the easiest and fastest; patient and observer comfort level increase with the convenience of evaluation of pleural effusion (PE) qualification, and assessment of quality and guidance for management is taken into consideration. Four plus one formula are taken for the existing literature, and the patient imaging evaluation and all the four plus one measurement are taken and calculated and kept for comparison. Later, the patient has aspirated patient PE catheter drainage done and calculated with the above four plus one measurement, and statistical analysis correlation is done. Aim: The aim of this study was to find the quantity, quality, and nature of PE in planning the management. Objectives: Primary objective - study to assess the nature of PE by clinical, sonography laboratory results. Secondary objective - To decide the mode of management and follow-up by diagnostic, therapeutic, closed pleural biopsy, pleuroscopy, video-assisted thoracoscopic surgery, and surgical decortication. Need of the Study: Because of the shape of pleural space and its anatomy, the PE volume variability in the estimation of actual quantity is complex subjectively even for an experienced clinician estimation or by computed tomography scan and sonography. Hence, instead of many available complicated clinical estimation and imaging formulae, the sonography formulae showed a wide spectrum of values in measuring the actual PE amount. This observational study was performed utilizing and comparing the available references and formulae. Sonography is modified to give the best comfort to patients and the most accessible and fastest sonographic t estimation and comparison with other groups of studies and to arrive at a consensus value for the purpose of our institutional uniformity. Study Site: Department of Radiology and Imaging Sciences and Department of Pulmonary Medicine, Apollo Hospitals, Chennai-06. Study Design: This was an observational, cross-sectional study. Study Duration: The duration of the study was March 2020–September 2021. Inclusion Criteria: patients with clinical suspicion of PE are taken up for study. Exclusion Criteria: patients with noncooperation and restless severe hydropneumothorax. The total number of patients is 181, both male and female, Equipment: High-end EPIQ-7G, PHILIPS ULTRASOUND machine with advanced feature and with broadband convex C5-1 transducer used, and all parameters are recorded systematically. If the fluid is beyond the image frame, we utilized a panoramic software view for any length of fluid, heightens the advantage in the study. Results: Balick et al. and our single measurement study were correlated, and we found in this study stresses on any axis, longest single measurement and position of the patient made easier for the estimation utilizing, highest hand equipment, having panoramic view software. Conclusion: Single-free longest axis measurement in this study is useful with the standard deviation of the single-fixed axis of measurements of other studies.