Measurement of intrapleural pressure in patients with spontaneous pneumothorax: a pilot study
Measurement of intrapleural pressure in patients with spontaneous pneumothorax: a pilot study
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DOI：
10.1186/s12890-019-1038-9
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发表时间：
2019-12-30
影响因子：
3.1
通讯作者：
Murakawa, Tomohiro
中科院分区：
文献类型：
--
作者：
Kaneda, Hiroyuki;Nakano, Takahito;Murakawa, Tomohiro
背景资料：气胸的初始治疗仍然存在争议，我们推测这可能是因为在初始治疗期间没有可用于评估漏气的方法。我们开发了一种用于测量气胸患者胸膜内压的系统，以解决漏气问题，而无需胸腔引流。本临床研究的目的是确认该测量系统的能力，并确定漏气管理的临床影响。方法：自发性气胸需要抽吸的患者入选本研究。在稳定呼吸期间测量胸膜内压，排除患者咳嗽时记录的数据。结果：2016年12月至2017年7月期间，11例患者入组本研究。胸膜内压的变化模式根据气胸的状态而变化很大。持续性漏气患者的吸气末和呼气末平均胸膜内压值显著低于无持续性漏气患者（p = 0.020）。持续性漏气患者的吸气末和呼气末平均负压记录数显著低于无持续性漏气患者（p = 0.0060）。结论：在本研究中，我们证明了气胸患者的胸膜内压可以成功测量和可视化。压力值是否是持续漏气的预测因子需要在将来确认。
Background: The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak.Methods: Patients in whom need aspiration was indicated for spontaneous pneumothorax were enrolled in the study. The intrapleural pressure was measured during stable breathing and data recorded when patients were coughing were excluded.Results: Eleven patients were enrolled in the study between December 2016 to July 2017. The patterns in change of intrapleural pressure varied widely depending on the state of the pneumothorax. The mean intrapleural pressure values on end-inspiration and end-expiration in patients with persistent air leak was significantly lower than those in patients without persistent air leak (p = 0.020). The number of negative mean pressure recordings in end-inspiration and end-expiration was significantly lower in patients with persistent air leak than in those without persistent air leak (p = 0.0060).Conclusions: In this study, we demonstrated that intrapleural pressure could be successfully measured and visualized in patients with pneumothorax. Whether or not the pressure value is a predictor of persistent air leak needs to be confirmed in the future.