Estimating the volume of chronic pleural effusions using transesophageal echocardiography

Abstract

Objective: To develop a simple method of quantifying the volume of chronic pleural effusions caused by heart failure using transesophageal echocardiography measurement of the maximum cross-sectional area of the pleural effusion.

Design: A prospective observational case series.

Setting: An operating room.

Participants: Twenty-eight patients undergoing cardiac surgery known to have chronic pleural effusions caused by heart failure diagnosed preoperatively in whom surgical management included draining the effusion.

Interventions: Transesophageal echocardiography was in situ for clinical reasons. The drainage of all pleural effusions was performed according to clinical judgement.

Measurement and main result: The maximum cross-sectional area (CSA(max)) in centimeters squared of the pleural effusion on transesophageal echocardiography was recorded. The chest and pleural cavity were opened, the pleural effusion was drained, and total amount of fluid drained was recorded. The data were analyzed on a log-log plot with the conclusion that volume (V) in milliliters could be estimated from the following formula: V = 4.5 · CSA(max)(3/2).

Conclusion: This study showed a simple way of quantifying the volume of chronic pleural effusions from heart failure in patients undergoing cardiac surgery, with potential for clinical applications.