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Does size matter concerning impact of position on oxygenation status in spontaneously breathing patients with unilateral effusion?

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Does size matter concerning impact of position on oxygenation status in spontaneously breathing patients with unilateral effusion?
Michaelides, S.A. Michailidis, A.-R. Bablekos, G.D. Analitis, A. Michalatou, M. Koulouris, N.
scientific_publication_article
Επιστημονική δημοσίευση - Άρθρο Περιοδικού (EL)
Scientific publication - Journal Article (EN)
2018
Background Inconsistent and contradictory findings have appeared in the literature concerning the impact of body position on oxygenation in pleural effusion. Methods We attempted to elucidate whether the size of the pleural effusion in patients with no parenchymal disease is the main determinant of posture-induced alterations in oxygenation parameters. We studied 62 spontaneously breathing patients aged 65.3±7.8 years (mean±SD), of whom 36 had large and massive-sized effusions (Group A) and 26 had small and moderate-sized effusions (Group B). Arterial blood gases were determined in four different body positions: Sitting (SIT), supine (SUP), ipsilateral (IPS) and contralateral (CON) to the effusion side, after remaining relaxed for at least 20 min in each position. Separation into groups A and B was deliberately set from the position of the fluid meniscus line on a posteroanterior chest film just above the upper costal margin of the sixth anterior rib. A two-way ANOVA model with outcome variables PaO 2, PaCO 2 and [A-a] DO 2 was used. Results In both groups the best oxygenation was found in SIT. The worst oxygenation (highest [A-a] DO 2 value) occurred in group A in CON compared with IPS (59.4±7.6 vs 49.0±7.5 mm Hg, p<0.001) and in group B in IPS compared with CON (51.0±8.7 vs 39.5±9.2 mm Hg, p<0.001). Also, PaCO 2 showed significant differences in both groups in IPS compared with CON (p=0.002). Conclusions Patients with large-sized effusions exhibit the worst oxygenation when lying on the side contralateral to the effusion, while those with small-sized effusions exhibit the worst oxygenation when lying on the side ipsilateral to the effusion. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. (EN)
English
Ερευνητικό υλικό ΕΚΠΑ
https://creativecommons.org/licenses/by-nc/4.0/
University of Athens
Pergamos Digital Library
Journal Article



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