[Pleural effusion in chronic obstructive pulmonary medicine (COPD) patients in a medical intensive care unit: characteristics and clinical implications]

Abstract

Background: Pleural effusions are common among patients admitted to an Intensive-Care Unit (ICU).

Aim: To retrospectively assess the role of pleural effusions in chronic obstructive pulmonary disease (COPD) patients admitted to a Medical ICU (MICU).

Patients and methods: We reviewed records of patients admitted over 12-months to the MICU with a diagnosis of COPD. We colLected clinical and laboratory data for their entire MICU stay. A radiologist reviewed all chest radiographs to determine the presence and estimated volume of pleural effusions.

Results: A total of 100 consecutive patients with COPD admitted to the MICU were included; 32 (32%) developed pleural effusions. COPD exacerbations were more common among patients without pleural effusion. Congestive heart failure (CHF) exacerbations were more common among patients with pleural effusions (p=0.001 and p=0.006, respectively). The length of stay was significantly longer among COPD patients with a pleural effusion (19 +/- 8 days) than those without it (14 +/- 3 days, p=0.001). The mortality rate was similar (40%) in both groups. Only patients with a large or unexplained effusion (19%) underwent thoracocentesis. In all cases, the pleural fluids were transudate and confirmed the diagnosis of CHF.

Conclusions: Pleural effusion is common among COPD patients admitted to a MICU. Most are due to CHF and parapneumonic effusions and respond well to treatment of the underlying problem.