Skip to main content
The Egyptian Journal of Bronchology
Download PDF

Prevalence, causes, and clinical implications of pleural effusion in pulmonary ICU and correlation with patient outcomes

Egyptian Journal of Bronchology volume 12, pages 247–252 (2018)Cite this article

Abstract

Introduction

Pleural effusion is common in medical ICU (MICU) patients, and it may develop owing to different causes and may affect patients outcomes.

Objective

The aim of this work was to study the prevalence and causes of pleural effusion in MICU and its effect on patient outcomes.

Patients and methods

A total of 90 patients admitted to MICU in Abbaseia Chest Hospital were included in the present study. The patients initially had pleural effusion or effusion developed during their ICU stay.

Results

Overall, 66 patients were males and 24 were females, and their mean age was 51.5±18.6 years. The prevalence rate of pleural effusion in our MICU during 1-year period was 12.7%. Pleural effusion was found to be exudates in 77.7% of cases and transudates in 22.3%. Uncomplicated parapneumonic effusion was the most common cause (36.7%), followed by heart failure (17.8%). The cause of pleural effusion did not significantly affect the patient outcome or duration of ICU stay. No significant reduction in duration of ICU stay or ICU mortality was seen in patients who received therapeutic aspiration or tube drainage compared with patients who received no specific management for effusion.

Conclusion

The commonest cause of pleural effusion in MICU is parapneumonic effusion, and chest ultrasonography is the best method of fluid detection. Different methods of management do not significantly affect patient outcomes.

References

  1. David M, Benson T, Helena W, Ware G. The diagnosis and management of pleural effusions in the ICU. J Intensive Care Med 2011;28:24–36.

    Google Scholar 

  2. Sahn S, Rippe J, Irwin R, Fink M. Pleural disease in the critically ill patien. I ntensive care medicine. 3rd ed. Boston:Little Brown 1995. 720–737

    Google Scholar 

  3. Zocchi L. Physiology and pathophysiology of pleural fluid turnover. Eur Respir J 2002;20:1545–1558.

    Article  CAS  Google Scholar 

  4. Fartoukh M, Azoulay E, Galliot R, Gall J, Baud F, Chevret S, et al. Clinically documented pleural effusions in medical ICU patients:how useful is routine thoracentesis? Chest 2002;121:178–184.

    Article  Google Scholar 

  5. Wiener M, Garay S, Leitman B. Imaging of the intensive care unit patient. Clin Chest Med 1991;12:169–197.

    CAS  PubMed  Google Scholar 

  6. Alexandre G, David C, Lared W, Sergio A. Diagnostic accuracy of sonography for pleural effusion. Sao Paulo Med J 2010;128:90–95.

    Article  Google Scholar 

  7. Chih Y, Huei W, Chun T, Chen H, Tsai K, Hung C, Shih H. Pleural effusions in febrile medical ICU patients. Chest 2004;126:1274–1280.

    Article  Google Scholar 

  8. Hooper C, Lee Y, Maskell N. Investigation of a unilateral pleural effusion in adults:British Thoracic Society pleural disease guideline. Thorax 2010? 65 (Suppl 2):ii4–ii17.

  9. Light RW. Pleural diseases. 5th ed. Baltimore:Lippincott Williams & Wilkins; 2007. 8–347.

    Google Scholar 

  10. Chang DB. Ultrasound guided pleural biopsy with true cut needle. Chest 1991;100:123–128.

    Article  Google Scholar 

  11. Chinchkar J, Talwar D, Jain K. A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short term evaluation of treatment. Lung India 2015;32:107–115.

    Article  Google Scholar 

  12. Mattison L, Coppage L, Alderman D, Herlong J, Sahn S. Pleural effusions in the medical ICU:prevalence, causes, and clinical implications. Chest 1997;111:1018–1023.

    Article  CAS  Google Scholar 

  13. Park T, Lee J, Park Y, Hoon C, Yim J, Yoo C, et al. Determination of the cause of pleural effusion in ICU patients with thoracentesis. Korean J Crit Care Med 2012;27:249–254.

    Article  Google Scholar 

  14. Motogna M, Maratou K, Paianid I. Application of color Doppler ultrasound in the study of small pleural effusion. Med Ultrason 2010;12:12–16.

    Google Scholar 

  15. Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Chest 2011;139:1140–1147.

    Article  Google Scholar 

  16. Tu C, Hsu W, Hsia T, Chen H, Tsai K, Hung C, et al. Pleural effusions in febrile medical ICU patients:chest ultrasound study. Chest 2004;126:1274–1280.

    Article  Google Scholar 

  17. Heidecker J, Huggins J, Sahn S. Pathophysiology of pneumothorax following ultrasound-guided thoracentesis. Chest 2006;130:1173–1184.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Ain Shams University, 43 ElMahrouky Street, 11341, Heliopolis, Cairo, Egypt

    Mohamed Farrag, Ahmed El Masry & Amr M. Shoukri MD

  2. Department of Chest Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Mona ElSayed

Authors
  1. Mohamed Farrag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed El Masry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amr M. Shoukri MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mona ElSayed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amr M. Shoukri MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farrag, M., Masry, A.E., Shoukri, A.M. et al. Prevalence, causes, and clinical implications of pleural effusion in pulmonary ICU and correlation with patient outcomes. Egypt J Bronchol 12, 247–252 (2018). https://doi.org/10.4103/ejb.ejb_117_17

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejb.ejb_117_17

Keywords