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Title:Merjenje tlakov plevralnega prostora med razbremenilno punkcijo (plevralna manometrija) kot varna in objektivna metoda pri ocenjevanju vpliva plevralnega izliva na izražanje simptomov
Authors:ID Meglič, Anita, Medicinska fakulteta UL (Author)
ID Adamič, Katja, Klinika Golnik (Author)
ID Dimitrić, Vladimir, Klinika Golnik (Author)
ID Nikolić, Vesna, Klinika Golnik (Author)
ID Rozman, Aleš, Klinika Golnik, Medicinska fakulteta UL (Author)
ID Marc-Malovrh, Mateja, Klinika Golnik, Medicinska fakulteta UL (Author)
Files:URL URL - Source URL, visit https://vestnik.szd.si/index.php/ZdravVest/article/view/3205/3665
 
URL URL - Source URL, visit https://vestnik.szd.si/index.php/ZdravVest/article/view/3205/3667
 
Language:Slovenian
Typology:1.01 - Original Scientific Article
Organization:Logo UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
Abstract:Izhodišča: Bolniki s plevralnim izlivom pogosto potrebujejo razbremenilno plevralno punkcijo (RPP), po kateri navajajo bolj ali manj izrazito olajšanje dispneje. Zaradi varnosti se priporoča, da se med RPP odstrani do 1.500 mL tekočine. Metode: V raziskavo smo vključili 96 bolnikov, pri katerih je bila potrebna RPP. Zbirali smo ocene stopnje dispneje na lestvici VAS pred, takoj po in 2 uri po RPP, pri 73 bolnikih pa še 24 ur po RPP ter beležili količino odstranjene tekočine. Med RPP smo z vodnim manometrom merili plevralne tlake, iz katerih smo izračunali elastanco plevralnega prostora in na podlagi meritev bolnike razdelili v skupine z različnimi elastančnimi krivuljami. Rezultati: Med začetnim plevralnim tlakom in količino odstranjene tekočine ter olajšanjem dispneje po opravljeni RPP smo ugotovili statistično značilno povezanost. Pri največjem deležu bolnikov smo RPP zaključili zaradi pojava simptomov, zaradi meritev plevralnega tlaka pa smo RPP prekinili pri 16 bolnikih (16,7 %). V skupino z normalno elastančno krivuljo smo uvrstili 74 bolnikov, nezmožnost razpenjanja pljuč pa smo ugotovili pri 22 bolnikih. Med RPP ni bilo pomembnih zapletov, kljub temu da smo več kot 1.500 mL izliva odstranili pri 32 (33 %) bolnikih. Zaključek: Višji začetni plevralni tlak je šibko povezan z višjo začetno stopnjo dispneje in večjim olajšanjem dispneje po opravljeni RPP. Najbolj uporabna je dinamika sprememb plevralnega tlaka, s katero lahko že med RPP prepoznamo nezmožnost razpenjanja pljuč. Med RPP s plevralno manometrijo lahko varno odstranimo tudi več kot 1.500 mL tekočine
Keywords:pljuča, dispneja, vizualna analogna lestvica, elastančne krivulje, nezmožnost razpenjanja pljuč
Publication date:02.05.2021
Place of publishing:Slovenija
Publisher:Slovensko zdravniško društvo
Year of publishing:2022
Number of pages:str. 91-99
Numbering:Vol. 91, št. 3/4
PID:20.500.12556/DiRROS-15399 New window
UDC:616.2
ISSN on article:1581-0224
DOI:10.6016/ZdravVestn.3205 New window
COBISS.SI-ID:113697539 New window
Copyright:(c) 2022 Zdravniški Vestnik
Note:Nasl. z nasl. zaslona; Soavtorji: Katja Adamič, Vladimir Dimitrić, Vesna Nikolić, Aleš Rozman, Mateja Marc Malovrh; Besedilo v slov.; Opis vira z dne 4. 7. 2022;
Publication date in DiRROS:29.08.2022
Views:781
Downloads:319
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Record is a part of a journal

Title:Zdravniški vestnik. glasilo Slovenskega zdravniškega društva
Shortened title:Zdr. vestn.
Publisher:Slovensko zdravniško društvo
ISSN:1581-0224
COBISS.SI-ID:124545792 New window

Licences

License:CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
Link:http://creativecommons.org/licenses/by-nc/4.0/
Description:A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.
Licensing start date:02.05.2021

Secondary language

Language:English
Title:Measurement of pleural pressure during therapeutic thoracentesis (pleural manometry) as a safe and objective method in the assessment of pleural effusion effect on symptom expression
Abstract:Background: Patients with pleural effusion often require therapeutic thoracentesis (TT), which results in more or less pronounced dyspnea relief. Due to safety concerns, it is recommended to remove up to a maximum of 1500 mL effusion in one session. Methods: 96 patients in whom TT was indicated were included in the study. VAS dyspnea score before, immediately after, two hours after TT, and in 73 patients additionally 24 hours after TT was collected. The amount of fluid removed was measured. During TT, water manometer was used to measure pleural pressures, from which pleural space elastance was calculated. Based on their elastance curves characteristics, the patients were divided into different groups. Results: We found a correlation between initial pleural pressure/volume of effusion removed and dyspnea relief after TT. TT was most often terminated due to the onset of symptoms, in 16 patients it was terminated due to pleural pressure measurement. 74 patients were classified in the group with a normal elastane curve, in 22 patients we detected unexpandable lungs. Although more than 1500 mL of effusion was removed in 32 (33%) patients, there were no important complications during TT. Conclusion: Higher initial pleural pressure is weakly correlated with higher initial dyspnea and greater dyspnea relief after TT. The dynamic of pleural pressure change is useful for detecting unexpandable lungs during TT. During TT with pleural manometry, more than 1500 mL of pleural fluid can be safely removed.
Keywords:lung, dyspnea, visual analogue scale, elastance curves, unexpandable lung


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