Improvements in the 6-min walk test and spirometry following thoracentesis for symptomatic pleural effusions.
BACKGROUND
Impairment in pulmonary capacity due to pleural effusion compromises daily activity. Removal of fluid improves symptoms, but the impact, especially on exercise capacity, has not been determined.


METHODS
Twenty-five patients with unilateral pleural effusion documented by chest radiograph were included. The 6-min walk test, Borg modified dyspnea score, FVC, and FEV(1) were analyzed before and 48 h after the removal of large pleural effusions.


RESULTS
The mean fluid removed was 1,564 ± 695 mL. After the procedure, values of FVC, FEV(1), and 6-min walk distance increased (P < .001), whereas dyspnea decreased (P < .001). Statistical correlations (P < .001) between 6-min walk distance and FVC (r = 0.725) and between 6-min walk distance and FEV(1) (r = 0.661) were observed. Correlations also were observed between the deltas (prethoracentesis × postthoracentesis) of the 6-min walk test and the percentage of FVC (r = 0.450) and of FEV(1) (r = 0.472) divided by the volume of fluid removed (P < .05).


CONCLUSIONS
In addition to the improvement in lung function after thoracentesis, the benefits of fluid removal are more evident in situations of exertion, allowing better readaptation of patients to routine activities.
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Ana Maria
AM
Cartaxo
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Francisco S
FS
Vargas
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
João Marcos
JM
Salge
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Bianca F
BF
Marcondes
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Eduardo H
EH
Genofre
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Leila
L
Antonangelo
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; Faculdade de Medicina de Jundiaí, Jundiaí, Brazil.
Evaldo
E
Marchi
Pleura Laboratory, Pulmonary Division-Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. Electronic address: lisetepneumo@yahoo.com.br.
Lisete R
LR
Teixeira
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D010996:Pleural Effusion / Q000503:physiopathology* / Q000628:therapy*; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*