Expiratory flow limitation in patients with pleural effusion.
BACKGROUND
Expiratory flow limitation (EFL) is one of the main mechanisms contributing to dyspnea in patients with chronic obstructive pulmonary disease but has not been explored in patients with pleural effusion.


OBJECTIVE
It was the aim of this study to determine whether patients with pleural effusion exhibit EFL and to investigate the effect of therapeutic thoracentesis on EFL.


METHODS
The study was performed on 21 patients with pleural effusion who were subjected to thoracentesis and measurement of pleural pressure (PP). Spirometry and estimation of flow limitation by the negative expiratory pressure technique were performed before and after thoracentesis.


RESULTS
Statistically significant differences were observed in all spirometric parameters. No correlation between the increase in lung volumes and flows and any of the aspirated fluid parameters was observed. Before thoracentesis, 14 out of 21 patients were flow limited, compared with 7 patients after thoracentesis (chi(2) = 6.151, p = 0.013). Mean values of flow limitation before and after thoracentesis differed significantly. The decrease in flow limitation did not correlate with the increase in the spirometric parameters, the aspirated fluid volume or PP decrease.


CONCLUSIONS
In the majority of patients with pleural effusion, flow limitation improves after thoracentesis. Flow limitation may be a contributing factor to the sensation of dyspnea in these patients.
Spyratos
D
D
Pulmonary Clinic, G. Papanicolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Sichletidis
L
L
Manika
K
K
Kontakiotis
T
T
Chloros
D
D
Patakas
D
D
D000368:Aged; D004322:Drainage; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000503:physiopathology* / Q000628:therapy; D013147:Spirometry; D016683:Supine Position / Q000502:physiology