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Observational Study
. 2023 Aug;67(7):943-952.
doi: 10.1111/aas.14258. Epub 2023 May 8.

Pleural effusion and thoracentesis in ICU patients: A longitudinal observational cross-sectional study

Karen W Fjaereide  1 , Per L Petersen  1 , Angela Mahdi  1 , Elena Crescioli  1   2 , Frederik M Nielsen  1   2 , Bodil S Rasmussen  1   2 , Olav L Schjørring  1   2
Affiliations
Observational Study

Pleural effusion and thoracentesis in ICU patients: A longitudinal observational cross-sectional study

Karen W Fjaereide et al. Acta Anaesthesiol Scand. 2023 Aug.

Abstract

Background: Pleural effusion is common among patients in the intensive care unit (ICU) but reported prevalence varies. Thoracentesis may improve respiratory status, however, indications for this are unclear. We aimed to explore prevalence, development, and progression of pleural effusion, and the incidence and effects of thoracentesis in adult ICU patients.

Methods: This is a prospective observational study utilizing repeated daily ultrasonographic assessments of pleurae bilaterally, conducted in all adult patients admitted to the four ICUs of a Danish university hospital throughout a 14-day period. The primary outcome was the proportion of patients with ultrasonographically significant pleural effusion (separation between parietal and visceral pleurae >20 mm) in either pleural cavity on any ICU day. Secondary outcomes included the proportion of patients with ultrasonographically significant pleural effusion receiving thoracentesis in ICU, and the progression of pleural effusion without drainage, among others. The protocol was published before study initiation.

Results: In total, 81 patients were included of which 25 (31%) had or developed ultrasonographically significant pleural effusion. Thoracentesis was performed in 10 of these 25 patients (40%). Patients with ultrasonographically significant pleural effusion, which was not drained, had an overall decrease in estimated pleural effusion volume on subsequent days.

Conclusion: Pleural effusion was common in the ICU, but less than half of all patients with ultrasonographically significant pleural effusion underwent thoracentesis. Progression of pleural effusion without thoracentesis showed reduced volumes on subsequent days.

Keywords: critical illness; intensive care units; observational study; pleural effusion; thoracentesis; ultrasonography.

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References

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