Abstract
BackgroundPleural effusion (PE) drainage can relieve the symptoms of dyspnea; however, details of the resulting hemodynamic changes remain undefined.MethodsSubjects older than 12 years with massive PE requiring pleural drainage were included in this study. Hemodynamic parameters were collected using transthoracic echocardiography at pre-drainage, immediately post-drainage, and 24 h after drainage.ResultsWe enrolled 47subjects in this prospective study from June 9, 2015 to September 18, 2016 in Beijing Chaoyang Hospital and 28 subjects were analyzed finally. Draining large-volume PE led to a progressive increase in left ventricular end-diastolic volume index, left atrial volume index, right ventricular area, right atrial area, left ventricular ejection fraction, stroke volume, and tricuspid annular plane systolic excursion, both immediately (P < 0.05) and 24 h after drainage (P < 0.05). The cardiac diastolic measurement ratios of early-transmitral flow velocity to diastolic mitral annular velocity and myocardial performance index decreased significantly following drainage (P < 0.05). More parameters were influenced by left-sided PE drainage. The correlation between effusion volume and changes in echocardiographic measurements was not statistically significant.ConclusionsImproved preload, and systolic and diastolic function is pivotal for hemodynamic change after draining large PE volumes. Subjects experienced improved cardiac hemodynamics following PE drainage, underlining the beneficial therapeutic and subjective effects.
Highlights
Pleural effusion (PE) drainage can relieve the symptoms of dyspnea; details of the resulting hemodynamic changes remain undefined
There were no significant differences in baseline values for age, smoking status, medical history, body surface area, effusion volume, and effusion appearance between the two groups (Table 1)
This study showed that drainage of large PE volumes led to an immediate increase in LV end-diastolic volume index (LVdVI), left atrial volume index (LAVI), Right ventricular (RV) area, and right atrial (RA) area for all enrolled subjects
Summary
Pleural effusion (PE) drainage can relieve the symptoms of dyspnea; details of the resulting hemodynamic changes remain undefined. Large-volume pleural effusion (PE) is a common complication causing breathlessness, and patients often experience dramatic and immediate relief from dyspnea after therapeutic thoracentesis [1]. It is a wellrecognized phenomenon, the detailed mechanism underlying witnessed improvements following drainage remains poorly understood [2]. The reasons for breathlessness caused by PE maybe multifactorial, but improvements in Previous studies have focused on the effects of PE on cardiovascular hemodynamics. Exactly when the hemodynamic change is most obvious remains unknown; evaluating the effect of drainage on the cardiovascular system at different points in
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