Impact of Draining Significant Effusion on Gas Exchange and Lung Mechanics in Patient Under Mechanical Ventilation

Study Overview
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Brief Summary
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Patients with acute respiratory failure (ARF) who were receiving mechanical ventilator support, had significant pleural effusion (both transudates and exudates) and drainage plan were evaluated. Decision to drain, timing and duration of drainage were made by primary physician according to the intensive care unit (ICU) protocols.The estimated amount of effusion (mL) was calculated as the maximum pleura-lung distance (mm) x 20 and significant effusion is accepted as ≥ 800 mL according to thoracic ultrasonography (USG) performed by the intensivist. The amount of effusion drained, mechanical ventilator parameters, arterial blood gas results and hemodynamic data were recorded before, at the 1st hour and at the end of drainage up to 30 days after drainage.

Conditions
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Respiration, Artificial, Pleural Effusion, Ultrasonography

Intervention / Treatment
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* Procedure: Drainage of the pleural effusion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients on mechanical ventilation due to acute respiratory failure Estimated effusion > 800 ml according to USG Have drainage plan according to ICU protocols decided by primary physician Exclusion Criteria: Have absolute drainage indication (empyema, hemothorax or chylothorax) predicted duration of mechanical ventilation less than 72 hours contraindications to drainage, underlying disease, which prevents lung expansion (chest deformity, central atelectasis) malignant effusions

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Drainage group<br>Patients under mechanical ventilator support due to acute respiratory failure who had significant pleural effusion and drainage plan according to the intensive Care Unit (ICU) protocols decided by primary physician | Procedure: Drainage of the pleural effusion<br> <br> * Other names: Thoracic Ultrasonography performed by USG certificated intensivist to the all subjects included in the study before drainage;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between estimated and drained effusion volume | Volume of the effusion estimated and drained was recorded (mL) | 1- Estimated effusion volume just before the drainage (by ultrasonography calculated as described in brief summary) 2- Drained effusion volume just after the drainage is terminated up to 30 days after procedure. | 
| Change in Lung mechanics | Dynamic Compliance (mL/cmH2O) | 1- Dynamic Compliance just before the drainage 2- Dynamic Compliance just after the drainage is terminated up to 30 days after procedure | 
| Change in Oxygenation | PaO2/FiO2 (fraction of inspired oxygen) | 1- PaO2/FiO2 just before the drainage 2- PaO2/FiO2 just after the drainage is terminated up to 30 days after procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pleural effusion, Mechanical Ventilation, Ultrasonography, Drainage