# Pleural effusion in difficult weaning from mechanical ventilation

M Dres, Daniel Roux, Thong Tien Pham, Muriel Fartoukh, Jd Ricard, A Demoule

► To cite this version:

M Dres, Daniel Roux, Thong Tien Pham, Muriel Fartoukh, Jd Ricard, et al. Pleural effusion in difficult weaning from mechanical ventilation. Intensive Care Medicine Experimental, 2015, 3 (Suppl 1), pp.A92. 10.1186/2197-425X-3-S1-A92. hal-01332342

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https://hal.sorbonne-universite.fr/hal-01332342

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POSTER PRESENTATION

Open Access

# Pleural effusion in difficult weaning from
mechanical ventilation

M Dres<fnref n="1" />,²*, D Roux³, T Pham<fnref n="1" />,⁴, M Fartoukh<fnref n="1" />,⁴, JD Ricard³, A Demoule<fnref n="1" />,²

From ESICM LIVES 2015
Berlin, Germany. 3-7 October 2015

**Introduction**

Pleural effusions (PE) are common in intensive care unit (ICU) patients, especially in patients under mechanically ventilation. Since PE can alter gas exchanges, one could hypothesize that PE could play a role in the outcome of weaning from mechanical ventilation.

However, no study has yet reported the incidence and
characteristics of PE in the specific context of weaning
failure.

Objectives

To describe the incidence of pleural effusion in patients
who failed a first spontaneous breathing trial (SBT) and
to describe the characteristics of these patients.

Methods

We conducted a prospective observational study in three
medical ICU. All mechanically ventilated patients were
screened daily. In patients who failed their first SBT, a
pleural ultrasonography was performed and the presence
of PE was qualitatively quantified according to a 4-steps
classification: 0: no PE; 1: small PE; 2: moderate PE and
3: large PE. In addition the main clinical characteristics
of patients were collected. For statistical analysis, patients
with classes 0 and 1 were regrouped, as were patients
with classes 2 and 3.

Results

From November 2014 to March 2015, 336 patients were
screened and 56 (17%) failed their first SBT. Among
them, 28 patients (50%) had no PE, 18 patients (32%) had
small PE (left or right), 8 (14%) patients had moderate PE
and 2 (4%) patients had large PE.

Patients with moderate and large PE stayed longer in ICU (19 ± 7 vs. 9 ± 7 days, p < 0.01) and had a longer duration of mechanical ventilation (14 ± 9 vs. 24 ± 12 days, p < 0.01) as compared with patients without PE and with small PE.

Patients with moderate or large PE and patients without PE or with small PE shared similar characteristics at admission (age: 66 ± 14 and 61 ± 15 and SAPS 2: 55 ± 18 53 ± 15, p > 0.05).

Shock as the cause of initiation of mechanical ventila-
tion was more frequent in patients with moderate and
large PE as compared to patients without and small PE
(40% vs. 4%, p < 0.01).

Only one patient with a large PE had a pleural evacuation but without clinical improvement.

Conclusions

Significant pleural effusion is often detected in difficult to wean patients (18%), and is associated with shock state as the reason for mechanical ventilation. The interest of pleural drainage in this population deserves further studies.

Authors’ details

¹Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.

²Hopital Pitie Salpetriere, Assistance Publique Hôpitaux de Paris, Respiratory and Critical Care Department, Paris, France. ³Assistance Publique - Hopitaux de Paris, Louis Mourier Hospital, Critical Care Department, Colombes, France.

⁴Assistance Publique - Hopitaux de Paris, Tenon Hospital, Critical Care Department, Paris, France.

Published: 1 October 2015

doi:10.1186/2197-425X-3-S1-A92

Cite this article as: Dres et al.: Pleural effusion in difficult weaning from mechanical ventilation. Intensive Care Medicine Experimental 2015 3(Suppl 1):A92.

<footnote n="1">¹Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
Full list of author information is available at the end of the article</footnote>