Bulletin européen de physiopathologie respiratoire
-
Bull Eur Physiopathol Respir · Jan 1984
Randomized Controlled Trial Clinical Trial[Pleural pressure during thoracocentesis in patients with pleural neoplasms].
In 45 patients with cancerous pleural effusion, thoracocentesis was performed according to the following technique : after local anaesthesia (5 ml of 2% lidocaine) in the posterior part of the 6th intercostal space, thoracocentesis was carried out with a blunt trocar connected to a water manometer. The pleural pressure was measured before removal of the fluid (Po). Then three different techniques of drainage (active suction at -- 80 or -- 40 mmHg or underwater sealed drainage) were randomized. ⋯ PT in these patients was statistically lower (-- 18 +/- 5.59 cmH2O) than in the 31 asymptomatic patients (--11.40 +/- 5.75 cmH2O) (p less than 0.001). In conclusion, the assessment of the pleural pressure during thoracocentesis seems to be convenient in order to prevent any complication of pleural evacuation : pleural evacuation should be stopped if the pleural pressure decreased below -- 18 cmH2O. A depression at -- 80 mmHg is too dangerous for pleural aspiration; -- 40 mmHg or under water sealed drainage are both convenient for a safe and complete evacuation.
-
Sulphur dioxide inhalation (200 ppm) suppresses the inflation apnea in rabbits, but not in dogs. In rabbits, SO2 blocks airway slowly adapting stretch receptors (SAR) while rapidly adapting irritant receptors (RAR) remain largely unaffected. We studied cough elicited by mechanical irritation of the extrapulmonary airways and larynx in 13 rabbits and 4 dogs, anesthetized and spontaneously breathing, before and after SO2 inhalation. ⋯ We recorded the response to mechanical probing of tracheal RAR, before and after SO2 exposure, in 6 rabbits. We found that the activity of these RAR was still present after cough and inflation apnea had disappeared. These results suggest a significant role of slowly adapting airway receptors in the cough reflex.