Effect of continuous positive airway pressure on fluid absorption among patients with pleural effusion due to tuberculosis.
BACKGROUND
Tuberculosis (TB) remains as an important public health problem worldwide. The most common type is pulmonary TB, and the most prevalent form of extra-pulmonary disease among HIV-negative patients is pleural disease.


OBJECTIVE
The objective of the present study was to determine the effect of continuous positive airway pressure (CPAP) on fluid absorption among patients with pleural effusion due to TB.


METHODS
Twenty patients were randomized into two groups. The interventional group (n=10) received CPAP three times a week during the initial four weeks of anti-TB treatment, and the control group (n=10) received anti-TB drugs only. The primary endpoint was the volume of pleural fluid after four weeks of treatment. Both groups were submitted to thoracic computed tomography using three-dimensional image reconstruction. The Mann-Whitney test for independent samples and the Wilcoxon paired samples test were used for statistical analysis. The normal distribution samples were analyzed using the unpaired t test.


RESULTS
The reduction of pleural effusion volume was significantly greater in the intervention group (83.5%+/-SD 3.6) than in the control group (36.9%+/-SD 2.9; p<0.001), and the final dyspnea index was lower in the Intervention group than in the control group (p=0.002).


CONCLUSIONS
Our findings indicate that CPAP during the first month of TB treatment accelerates the absorption of pleural effusion, however, additional studies are needed to confirm these findings and evaluate the impact of CPAP on pleural sequelae after the end of anti-TB treatment. Article registered in the Clinical Trials under the number NCT00560521.
Oliveira
Juliana F
JF
Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brazil.
Mello
Fernanda C Q
FC
Rodrigues
Rosana S
RS
Boechat
Ana L
AL
Conde
Marcus B
MB
Menezes
Sara L S
SL
D000042:Absorption; D000328:Adult; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000209:etiology* / Q000628:therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D014397:Tuberculosis, Pulmonary / Q000150:complications*