Photo Credit: Sopone Nawoot
The following is a summary of “Management of Pleural Effusion in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Guideline,” published in the December 2024 issue of Surgery by Chiu et al.
People who are critically ill and on mechanical ventilation often develop pleural effusions, which can reduce lung compliance and impair lung expansion.
Researchers conducted a retrospective study to assess how pleural effusion is managed in critically ill people on mechanical ventilation.
They conducted a comprehensive literature search and included 28 studies in the review. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the quality of evidence and develop recommendations.
The results showed that draining the pleural effusion led to a mean increase in the PaO2 /FiO2 ratio of 53 (P<0.00001, 95% CI: 43–64, I2 = 0%) compared to people who did not undergo drainage. In people with drainage, the combined incidence of pneumothorax was 2.1% (124/5,995).
They concluded that draining pleural effusion was recommended to improve oxygenation in critically ill people on mechanical ventilation, especially when the PaO2 /FiO2 ratio was less than 200 and the estimated volume of pleural effusion was more significant than 500 mL, while intervention could significantly benefit people experiencing hypoxia related to pleural effusion.
Source: americanjournalofsurgery.com/article/S0002-9610(24)00696-2/abstract
