title: [Pleural effusion in chronic obstructive pulmonary medicine (COPD) patients in a medical intensive care unit: characteristics and clinical implications].
abstract: BACKGROUND
  Pleural effusions are common among patients admitted to an Intensive-Care Unit (ICU).
  
  
  OBJECTIVE
  To retrospectively assess the role of pleural effusions in chronic obstructive pulmonary disease (COPD) patients admitted to a Medical ICU (MICU).
  
  
  METHODS
  We reviewed records of patients admitted over 12-months to the MICU with a diagnosis of COPD. We colLected clinical and laboratory data for their entire MICU stay. A radiologist reviewed all chest radiographs to determine the presence and estimated volume of pleural effusions.
  
  
  RESULTS
  A total of 100 consecutive patients with COPD admitted to the MICU were included; 32 (32%) developed pleural effusions. COPD exacerbations were more common among patients without pleural effusion. Congestive heart failure (CHF) exacerbations were more common among patients with pleural effusions (p=0.001 and p=0.006, respectively). The length of stay was significantly longer among COPD patients with a pleural effusion (19 +/- 8 days) than those without it (14 +/- 3 days, p=0.001). The mortality rate was similar (40%) in both groups. Only patients with a large or unexplained effusion (19%) underwent thoracocentesis. In all cases, the pleural fluids were transudate and confirmed the diagnosis of CHF.
  
  
  CONCLUSIONS
  Pleural effusion is common among COPD patients admitted to a MICU. Most are due to CHF and parapneumonic effusions and respond well to treatment of the underlying problem.
authors.affiliation: Pulmonary Department, Meir Medical Center, Kfar Saba, Israel, affiliated with Sackler Faculty of Medicine, Echocardiography Unit, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alona
authors.initials: A
authors.lastname: Meveychuck
authors.forename: Alexandra
authors.initials: A
authors.lastname: Osadchy
authors.forename: Baruch
authors.initials: B
authors.lastname: Chen
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008875:Middle Aged; D019152:Paracentesis; D010996:Pleural Effusion / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies