Abstract
Introduction: Pleura effusion is a common condition causing dyspnea as major symptom. Pathophysiological pathways leading to dyspnea are poorly understood. Only minimal change in lung volumes is seen. Dysfunction of respiratory mechanics may be a factor. We aimed to study change in diaphragmatic function following pleuracentesis.
Methods: Patient undergoing pleuracentesis were eligible for participation. Ultrasound evaluation of diaphragmatic movement at the side of pleural effusion was recorded before and after pleuracentesis with the Area method. Primary outcome was reduction of dyspnea, assessed on the mBorg scale, and change in peripheral oxygen saturation.
Results: Thirty-two patients were included. Pleuracentesis reduced dyspnea from 5.01 (95%CI 4.12-6.04) to 2.6 (95%CI 1.87-3.4), p<0.0001. Saturation increased with 1.28 (95%CI 0.47-2.1) points, p=0.003. Hemi-diaphragmatic movement improved with 17.4 cm2 (95%CI 13.04-21.08), p<0.0001. In mean 1,283 ml (95%CI 1113-1452) was drained.
Conclusion: Pleuracentesis reduces dyspnea and restores diaphragmatic function without clinically relevant change in peripheral oxygenation. These findings show that the diaphragm plays a central pathophysiological role in pleural effusion-related dyspnea. Dyspnea may be more related to respiratory mechanistic factors rather than to hypoxemia.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA5363.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019