Year 2019 Vol. 27 No 1




Omsk State Medical University 1,
A.N. Kabanov Omsk City Clinical Hospital №1 2, Omsk,
The Russian Federation

Objective. To determine the prognostic value of the fluctuations of the intrapleural pressure associated with the act of breathing during thoracocentesis and draining of fluid from the pleural cavity.
Methods. The study included 36 patients who suffered from pleural effusion and underwent thoracentesis. The continuous intrapleural manometry during the procedure was performed. Then control examinations included repeated examination, chest X-ray and ultrasound examination of the pleural cavities. According to their results, patients were divided into 3 groups: group 1 – patients with straightened lungs and without complications (n=18), group 2 – patients with unexpandable lung (n=18), subgroup 2-1 – patients, which thoracocentesis, complicated by pneumothorax (n=6). The comparison criteria were the volume of the removed liquid (ml), the mean intrapleural pressure (cm H2O), the amplitude of the pressure fluctuations associated with the act of breathing, between the inspiration and expiration peaks in quiet breathing before and after the removal of the liquid (cm H2O), the pleural elasticity and change of amplitude of the pressure fluctuations after the draining.
Results. It was found that association among the pleural elasticity and the amplitude change and unexpandable lung were statistically significant (p=0.00283). It was also found out that, with the development of pneumothorax, an increase in pleural elasticity is associated with a decrease in intrapleural pressure fluctuations (p=0.00199). There were no significant associations of development of unwanted outcomes with other comparison criteria.
Conclusions. Association with outcomes is confirmed for pleural elasticity and change of the amplitude of the fluctuations of intrapleural pressure associated with the act of breathing. An objective predictor of unexpandable lung, as well as the occurrence of pneumothorax after thoracocentesis, along with an elevation of pleural elasticity, is a decrease in the amplitude of oscillations of pleural pressure associated with the act of breathing.

Keywords: pleural effusion, intrapleural pressure, thoracentesis, pneumothorax, unexpandable lung, pleural manometry
p. 26-34 of the original issue
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Address for correspondence:
644112, The Russian Federation,
Omsk, Perelet Str., 7,
Omsk State Medical University,
General Surgery Department.
Tel. +7 913 621 48 03,
Algis R. Khasanov
Information about the authors:
Khasanov Algis R., Post-Graduate Student, General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Korzhuk Mikhail S., MD, Professor, Head of General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Bezmozgin, Kirill G., Thoracic Surgeon, A.N. Kabanov Omsk City Clinical Hospital №1, Omsk, Russian Federation.
Zhukova Olga O., Intern of General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Kinzerskiy, Alexander A., Post-Graduate Student, General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
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