RT Journal Article
SR Electronic
T1 Computed tomography measurements of parapneumonic effusion indicative of thoracentesis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00045-2011
DO 10.1183/09031936.00004511
A1 B.K. Moffet
A1 T.S. Panchabhai
A1 I. Anaya
A1 R. Nakamatsu
A1 F.W. Arnold
A1 P. Peyrani
A1 T. Wiemken
A1 J. Guardiola
A1 J.A. Ramirez
YR 2011
UL http://erj.ersjournals.com/content/early/2011/05/26/09031936.00004511.abstract
AB Patients with parapneumonic effusions (PPE) that measure <1 cm by lateral decubitus radiograph (LDR) or <5 cm by lateral erect radiograph (LER) do not require thoracentesis. No such data exists for chest computed tomography (CCT). The objective of this study was to identify a PPE measurement by CCT that indicates the need for thoracentesis.A secondary data analysis of two pneumonia databases was conducted to identify patients with PPE. Measurements of PPE using LDR, LER, and CCT were correlated by linear regression analysis. The clinical outcome of community acquired pneumonia patients managed with the newly defined CCT measurement was evaluated.PPE was identified in 419 of 1,460 patients with possible pneumonia. PPE measurements by LDR of 1.00 cm and 5.00 cm by LER correlated with a measurement of 2.5 cm by CCT. Out of 95 patients with CCT measurements <2.50 cm, 31 poor clinical outcomes occurred: 1 outcome was PPE related, 26 were PPE unrelated, and 4 were unevaluable. The single case of a poor outcome also measured <1.00 cm by LDR.This study indicates that patients with CAP and a PPE measuring <2.50 cm by CCT can be managed without the need for thoracentesis.