Assessment of Pleural Pressure in the Evaluation of Pleural Effusions

Abstract

Pleural effusion is diagnosed in approximately 1.5 million patients each year in the United States, making therapeutic thoracentesis one of the most commonly performed medical procedures. 1 Light RW Pleural diseases. 4th ed. Lippincott Williams & Wilkins, Philadelphia, PA2001 Google Scholar Although investigations into pleural pressures have been undertaken for > 120 years, 2 Quincke H Ueber den druck in transudaten. Dtsch Arch Klin Med. 1878; 21: 453-468 Google Scholar the clinical use of pleural manometry has become increasingly popular only over the past 3 decades. Despite the high incidence of malignant pleural effusions, which account for approximately 36% of all effusions subject to thoracentesis, 3 Villena V Lopez EA Echave-Sustaeta J et al. Prospective study of 1,000 consecutive patients with pleural effusion: etiology of the effusion and characteristics of the patients. Arch Bronconeumol. 2002; 38: 21-26 Crossref PubMed Google Scholar few data concern the prevalence of nonexpandable lung due to lung entrapment or trapped lung in this patient population. This first “Interactive Physiology Grand Rounds” is written with the goals of improving the overall understanding of the physiology underlying the use and interpretation of pleural manometry and elucidating the important role pleural manometry can play in the therapeutic algorithm of patients with malignant pleural effusion. Interactive Physiology Grand Rounds: Introduction to the SeriesCHESTVol. 135Issue 1PreviewPhysiology is dead. Or at least that is what one might think as many medical schools disbanded their physiology departments in the past few years or absorbed them into departments of cell biology. Systems biology is the new integrative discipline, purporting to study the entire organism, but its focus is more on the genes, proteins, and biochemical reactions that sustain life than on the interaction of organs and organ systems. At the core of clinical care, however, the interpretation of symptoms such as shortness of breath and chest pain, the application of findings on physical examination to disease states, and so much of what we do daily at the patient bedside are intimately connected to our knowledge of physiology. Full-Text PDF