Pleural Manometry in Thoracocentesis
Thoracocentesis of Pleural Effusion
About this trial
This is an interventional diagnostic trial for Thoracocentesis of Pleural Effusion
Eligibility Criteria
Inclusion Criteria:
- age between 18 and 85 years,
- pleural effusion occupying at least one-third of the ipsilateral hemithorax in P-A chest radiograph (CXR)
- no contraindications for therapeutic thoracentesis
- general health condition allowing prolonged procedure of therapeutic thoracentesis.
Exclusion Criteria:
- patients with very small amounts of pleural effusion
- patients on mechanical ventilation
- patients using anticoagulant therapy
- patients refusing to be subjected to thoracocentesis.
Sites / Locations
- Cardiothoracic Surgery Hospital, Faculty of Medicine, Ain Shams University
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Manometer Group
Conventional Group
Therapeutic thoracentesis will be performed in a sitting position. wide bore catheter as a pleural catheter will be inserted into the pleural cavity. simple water manometer will be connected to the pleural catheter via 3-way adapter.connected to the infusion lines with one draining into the drainage collection bottle and the other pre-flushed with normal saline hanging down till 40 cm below the puncture site and then rising up (forming a "U") with the ascending arm taped to the IV stand. baseline pleural pressure will be registered before the beginning of pleural fluid withdrawal. Pleural pressure curve will subsequently be registered after the withdrawal of each 200 ml of pleural fluid up to a total volume of 1000 ml.
Therapeutic thoracentesis will be performed in a sitting position. The skin will be cleaned with betadine antiseptic solution. Pleural aspiration should take place in a clean area using full aseptic techniques. 5-10 cc Lidocaine 2% will be given as local anesthetic in the site of puncture. the IV cannula is advanced till fluid is aspirated. Then, the needle is withdrawn and the catheter is fixed to two 3-way adapters fixed in series placed in between. connected to the infusion lines with one draining into the drainage collection bottle.