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(Chest. 1995;107:1610-1614.)
© 1995 American College of Chest Physicians

Changes in Pulmonary Mechanics and Gas Exchange After Thoracentesis on Patients With Inversion of a Hemidiaphragm Secondary to Large Pleural Effusion

Jeng-Shing Wang MD, FCCP1 and C. Howard Tseng MD, PhD2

1 From the Emergency Medicine Department, Chang-Gung Memorial Hospital at Kaohsiung, Taiwan, ROC.
2 From the Pathology Department, Yuan's General Hospital, Kaohsiung, Taiwan, ROC.

The present study was designed to test whether there was a significant improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis on patients with inversion of a hemidiaphragm due to pleural effusion. In 21 patients with inversion of a hemidiaphragm because of a pleural effusion, we studied the changes in pulmonary mechanics and gas exchange that occurred in 24 h after removal of 600 to 2,700 mL of fluid by thoracentesis. There was a small but significant increase in the forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) (p<0.001). The alveolar-arterial oxygen gradient (P[A-a]O2) and partial pressure of arterial oxygen (PaO2) showed a significant increase (p<0.001), but there was no change in partial pressure of arterial carbon dioxide (PaCO2). In the present study, all patients with a large pleural effusion had inversion of a hemidiaphragm documented by chest sonography, and that was an important factor to observe significant improvement in pulmonary mechanics and gas exchange.

Key Words: artery blood gas • chest sonography • inversion of a hemidiaphragm • pulmonary function test • thoracentesis

Submitted on May 24, 1994
Accepted on October 5, 2007




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