• Chest · Mar 2014

    Should thoracentesis be done in parapneumonic pleural effusion with a small volume?

    • Sagrario Mayoralas Alises, Patricia Lazo Meneses, Esteban Perez Rodriguez, Carolina Gotera, Deisy Barrios Barreto, Salvador Diaz Lobato, Carolina Jurkojc Mohremberger, and Maria Galarza Jimenez.
    • Chest. 2014 Mar 1;145(3 Suppl):288A.

    Session TitlePleuralSESSION TYPE: Slide PresentationsPRESENTED ON: Sunday, March 23, 2014 at 04:15 PM - 05:15 PMPURPOSE: Evaluate whether thoracentesis is necessary in all parapneumonic effusions regardless of volumeMethodsWe conducted a retrospective review of 2413 patients with pleural effusion included in the pleura unit database of the Ramón y Cajal Hospital from 1994 through October 2011. Cases were studied according to the guidelines of the unit: age, sex, pretest diagnosis, risk factor, volume and location, pleural fluid character, extraction volume, pH, biochemical parameters (protein, LDH, albumin, glucose, cholesterol, triglycerides, ADA), cell count, cytology, microbiology if the Pretest diagnosis is parapneumonic and biopsy if the Pretest diagnosis is tuberculosis, malignant or generic pleural exudate. All cases were closed with a final diagnosis. Out from the total effusions assessed, 349 (14,5%) were parapneumonics, of which 73 were empyema. In all cases volume, pH, LDH, microbiology and pus were analysed. According to volume, 4 groups were assessed (<10%; 11 to 20%, 21 to 50% and >50%). The volume was assessed by two pulmonologists. Different volume groups were correlated as per volume levels with known prognostic parameters (pH, LDH, pus and microbiology). The completed statistical analysis was descriptive, with average and SD.ResultsOut of the 349 (14,5%) pleural effusions, 276 (11,5%) were parapneumonic and 73 (3%) were empyema, from which 242 (69,3%) were registered in men and 107 in women (30,7%) with an average age of 62,3 with 18,871 of Typical Deviation. Out of the 349 patients with pleural effusion, 109 (33,2%) were found to have a pleural fluid volume <10%, 89 (27,1%) from 11% to 20%, 97 (29,6%) between 21-50% (27,8%) and 33 patients were found levels >50%, representing the (10,1%) of all the parapneumonics pleural effusions. It was observed that of all pleural effusions studied in this series (349) 38 were of purulent content (10,88%) distributed regardless of the volume of the pleural fluid.ConclusionsAll parapneumonic effusions should be studied by thoracentesis, including those showing low volume levels, as these could be associated with poor prognostic parameters of bad condition progress.Clinical ImplicationsThe study of all parapneumonic effusions may prevent serious complications or detect them early reducing morbidity and improving healthcareDisclosureThe following authors have nothing to disclose: Maria Galarza Jimenez, Deisy Barrios Barreto, Esteban Perez Rodriguez, Carolina Gotera, Patricia Lazo Meneses, Carolina Jurkojc Mohremberger, Salvador Diaz Lobato, Sagrario Mayoralas AlisesNo Product/Research Disclosure Information.

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