Early pleural fluid dynamics following video-assisted thoracoscopic lobectomy has limited clinical value.
JOURNAL OF THORACIC DISEASE(2017)
摘要
The objective of this study was to evaluate the potential of predicting the pleural fluid output in patients after video-assisted thoracoscopic lobectomy of the lung. Detailed measurements of continuous fluid output were obtained prospectively using an electronic thoracic drainage device (Thopaz+(TM) Medela AG, Switzerland). Patients were divided into high (>= 500 mL) and low (< 500 mL) 24-hour fluid output, and detailed flow curves were plotted graphically to identify arithmetic patterns predicting fluid output in the early (<= 24 hours) and later (24-48 hours) post-operative phase. Furthermore, multiple logistic regression analysis was used to predict high 24-hour fluid output using baseline data. Data were obtained from 50 patients, where 52% had a fluid output of < 500 mL/24 hours. From visual assessment of flow curves, patients were grouped according to fluid output 6 hours postoperatively. An output >= 200 mL/6 hours was predictive of 'high 24-hour fluid output' (P < 0.0001). However, 33% of patients with < 200 mL/6 hours ended with a 'high 24-hour fluid output'. Baseline data showed no predictive value of fluid production, and 24-hour fluid output had no predictive value of fluid output between 24 and 48 hours. Assessment of initial fluid production may predict high 24-hour fluid output (>= 500 mL) but seems to lack clinical value in drain removal criteria.
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关键词
Chest tubes,video-assisted thoracic surgery,pleural effusion,lung neoplasms,enhanced recovery after surgery
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