Journal Information
Vol. 42. Issue 7.
Pages 349-372 (July 2006)
Vol. 42. Issue 7.
Pages 349-372 (July 2006)
Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
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Diagnosis and Treatment of Pleural Effusion
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75859
Victoria Villena Garridoa,
, Jaime Ferrer Sanchob, Hernández Blascoc, Alicia de Pablo Gafasd, Esteban Pérez Rodrígueze, Francisco Rodríguez Panaderof, Santiago Romero Candeirac, Ángel Salvatierra Velázquezg, Luis Valdés Cuadradoh, Assembly on Transplantation and Transplant Techiques SEPAR
Corresponding author
mvg01m@saludalia.com
Correspondence: Dr. V. Villena Garrido. Servicio de Neumología. Hospital 12 de Octubre. Avda. de Córdoba, s/n. 28041 Madrid. España
Correspondence: Dr. V. Villena Garrido. Servicio de Neumología. Hospital 12 de Octubre. Avda. de Córdoba, s/n. 28041 Madrid. España
a Hospital Universitario 12 de Octubre, Madrid, Spain
b Hospital Vall d'Hebron, Barcelona, Spain
c Hospital General Universitario, Alicante, Spain
d Clínica Puerta de Hierro, Madrid, Spain
e Hospital Ramón y Cajal, Madrid, Spain
f Hospital Virgen del Rocío, Seville, Spain
g Hospital Reina Sofía, Cordoba, Spain
h Hospital de Conxo, Santiago de Compostela, La Coruña, Spain
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References
[1]
Textbook of pleural diseases,
[2]
Villena V, López Encuentra E, García-Luján R, et al.
Clinical implications of appearance of pleural fluid at thoracentesis.
Chest, 125 (2004), pp. 156-159
[3]
Cheng DS, Rodríguez RM, Rogers J, et al.
Comparison of pleural fluid pH values obtained using blood gas machine, pH meter, and pH indicator strip.
Chest, 114 (1998), pp. 1368-1372
[4]
Jiménez-Castro D, Díaz G, Pérez-Rodríguez E, et al.
Modification of pleural fluid pH by local anesthesia.
Chest, 116 (1999), pp. 399-402
[5]
Heffner JE, Brown LK, Barbieri C, et al.
Pleural fluid chemical analysis in parapneumonic effusions. A metaanalysis.
Am J Respir Crit CareMed, 151 (1995), pp. 1700-1708
[6]
Rodríguez-Panadero F, López Mejías J.
Low glucose and pH levels in malignant pleural effusions. Diagnostic significance and prognostic value in respect to pleurodesis.
Am Rev Respir Dis, 139 (1989), pp. 663-667
[7]
Jiménez D, Pérez Rodríguez E, Díaz G, et al.
Determining the optimal number of specimens to obtain with needle biopsy of the pleura.
Respir Med, 96 (2002), pp. 14-17
[8]
Porcel JM, Vives M.
Etiology and pleural fluid characteristics of large and massive effusions.
Chest, 124 (2003), pp. 978-983
[9]
Ferrer J, Roldán J, Teixidor J, et al.
Predictors of pleural malignancy in patients with pleural effusion undergoing thoracoscopy.
Chest, 127 (2005), pp. 1017-1022
[10]
Ferrer JS, Muñoz XG, Orriols RM, et al.
Evolution of idiopathic pleural effusion: a prospective, long-term follow-up study.
Chest, 109 (1996), pp. 1508-1513
[11]
Romero Candeira S, Hernández Blasco L, Romero Brufao S.
Trasudados frente a exudados pleurales. Criterios discriminantes. Causas de trasudado pleural y aproximación diagnóstica.
Enfermedades de la pleura. Monografías Neumomadrid, pp. 57-68
[12]
Romero-Candeira S, Hernández L.
The separation of transudates and exudates with particular reference to the protein gradient.
Curr Opin Pulm Med, 10 (2004), pp. 294-298
[13]
Sahn SA.
Management of complicated parapneumonic effusions.
Am Rev Respir Dis, 148 (1993), pp. 813-817
[14]
Chen KY, Hsueh PR, Liaw YS, et al.
A 10-year experience with bacteriology of acute thoracic empyema: emphasis on Klebsiella pneumoniae in patients with diabetes mellitus.
Chest, 117 (2000), pp. 1685-1689
[15]
Maskell NA, Davis CWH, Nunn AJ, et al.
U.K. controlled trial of intrapleural streptokinase for pleural infection.
N Engl J Med, 352 (2005), pp. 865-874
[16]
Davies CW, Kearney SE, Gleeson FV, et al.
Predictors of outcome and long-term survival in patients with pleural infection.
Am J Respir Crit Care Med, 160 (1999), pp. 1682-1687
[17]
Maskell NA, Gleeson FV, Darby M, et al.
Diagnostically significant variations in pleural fluid pH in loculated parapneumonic effusions.
Chest, 126 (2004), pp. 2022-2024
[18]
Heffner JE.
Indications for draining a parapneumonic effusion: an evidence-based approach.
Semin Respir Infect, 14 (1999), pp. 48-58
[19]
Colice GL, Curtis A, Deslauriers J, et al.
Medical and surgical treatment of parapneumonic effusions: an evidence-based guideline.
Chest, 118 (2000), pp. 1158-1171
[20]
Jordà Marcos R, Torres Martí A, Ariza Cardenal FJ, et al.
Recomendaciones para el tratamiento de la neumonía intrahospitalaria grave.
Arch Bronconeumol, 40 (2004), pp. 518-533
[21]
Grupo de Estudio de la Neumonía Adquirida en la Comunidad.
Normativas para el diagnóstico y el tratamiento de la neumonía adquirida en la comunidad. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).
Arch Bronconeumol, 41 (2005), pp. 272-289
[22]
Texeira LR, Villarino MA.
Antibiotic treatment of patients with pneumonia and pleural effusion.
Curr Opin Pulm Med, 4 (1998), pp. 230-234
[23]
Cameron R, Davies HR.
Intra-pleural fibrinolytic therapy versus conservative management in the treatment of parapneumonic effusions and empyema.
Cochrane Database Syst Rev, (2004), pp. CD002312
[24]
Vidal R, de Gracia J, Ruiz J, et al.
Estudio controlado de 637 pacientes con tuberculosis: diagnóstico y resultados terapéuticos con esquemas de 9 y 6 meses.
Med Clin (Barc), 87 (1986), pp. 368-370
[25]
Valdés L, Álvarez D, San José E, et al.
Tuberculous pleurisy: a study of 254 cases.
Arch Intern Med, 158 (1998), pp. 2017-2021
[26]
Greco S, Girardi E, Masciangelo R, et al.
Adenosine deaminase and interferon gamma measurements for the diagnosis of tuberculous pleurisy: a meta-analysis.
Int J Tuberc Lung Dis, 7 (2003), pp. 777-786
[27]
Burgess LJ, Maritz FJ, Le Roux I, et al.
Combined use of pleural adenosine deaminase with lymphocyte/neutrophil ratio. Increased specificity for the diagnosis of tuberculosis pleuritis.
Chest, 109 (1996), pp. 414-419
[28]
Valdés L, San José E, Álvarez D, et al.
Diagnosis of tuberculous pleurisy using the biologic parameters adenosine deaminase, lysozyme, and interferon gamma.
Chest, 103 (1993), pp. 458-465
[29]
Valdés L, San José E, Álvarez D, et al.
Adenosine deaminase (ADA) isoenzyme analysis in pleural effusions: diagnostic role and relevance to the origin of increased ADA in tuberculous pleurisy.
Eur Respir J, 9 (1996), pp. 747-751
[30]
Villena V, López-Encuentra A, Pozo F, et al.
Interferon gamma levels in pleural fluid for the diagnosis of tuberculosis.
Am J Med, 115 (2003), pp. 365-370
[31]
Sharma SK, Banga A.
Pleural fluid interferon-γ and adenosine deaminase levels in tuberculosis pleural effusion: a cost-effectiveness analysis.
J Clin Lab Anal, 19 (2005), pp. 40-46
[32]
Pai M, Flores LL, Hubbard A, et al.
Nucleid acid amplification tests in the diagnosis of tuberculous pleuritis: a systematic review and metaanalysis.
BMC Infectious Diseases, 4 (2004), pp. 6-20
[33]
Blumberg HM, Burman WJ, Chaisson RE, et al.
American Thoracic Society/Centers for Diseases Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis.
Am J Respir Crit Care Med, 167 (2003), pp. 603-662
[34]
Lai YF, Chao TY, Wang YH, et al.
Pigtail drainage in the treatment of tuberculous pleural effusions: a randomised study.
Thorax, 58 (2003), pp. 149-152
[35]
Matchaba PT, Volmink J.
Steroids for treating tuberculous pleurisy (Cochrane Review).
The Cochrane Library, Issue 1, Update Software, (2001),
[36]
Sahn SA, Good JT Jr.
Pleural fluid pH in malignant effusions. Diagnostic, prognostic, and therapeutic implications.
Ann Intern Med Med, 108 (1988), pp. 345-349
[37]
Ceyhan BB, Demiralp E, Celikel T.
Analysis of pleural effusions using flow cytometry.
Respiration, 63 (1996), pp. 17-24
[38]
Antony VB, Loddenkemper R, Astoul P, et al.
Management of malignant pleural effusions.
Am J Respir Crit Care Med, 162 (2000), pp. 1987-2001
[39]
Antunes G, Neville E, Duffy J, et al.
BTS guidelines for the management of malignant pleural effusions.
Thorax, 58 (2003), pp. 29-38
[40]
Escudero Bueno C, García Clemente M, Cuesta Castro B, et al.
Cytologic and bacteriologic analysis of fluid and pleural biopsy specimens with Cope's needle. Study of 414 patients.
Arch Inter Med, 150 (1990), pp. 1190-1194
[41]
Villena V, López Encuentra A, Echave-Sustaeta J, et al.
Estudio prospectivo de 1.000 pacientes consecutivos con derrame pleural. Etiología del derrame y características de los pacientes.
Arch Bronconeumol, 38 (2002), pp. 21-26
[42]
Maskell NA, Gleeson FV, Davies RJ.
Standard pleural biopsy versus CT guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial.
Lancet, 361 (2003), pp. 1326-1330
[43]
Boutin C, Viallat JR, Cargnino P, et al.
Thoracoscopy in malignant pleural effusions.
Am Rev Respir Dis, 124 (1981), pp. 588-592
[44]
Loddenkemper R, Grosser H, Gabler A, et al.
Prospective evaluation of biopsy methods in the diagnosis of malignant pleural effusions: intrapatient comparison between pleural fluid cytology, blind needle biopsy and thoracoscopy.
Am Rev Respir Dis, 127 (1983), pp. 114
[45]
Villena V, Lopez-Encuentra A, Pozo F, et al.
Measurement of pleural pressure during therapeutic thoracentesis.
Am J Respir Crit Care Med, 162 (2000), pp. 1534-1538
[47]
Dresler CM, Olak J, Herndon JE II, et al.
Phase III Intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion.
Chest, 127 (2005), pp. 909-915
[48]
Shaw P, Agarwal R.
Pleurodesis for malignant pleural effusions.
Cochrane Database Syst Rev, (2004), pp. CD002916
[49]
Ferrer J, Montes JF, Villarino MA, et al.
Influence of particle size on extrapleural talc dissemination after talc slurry pleurodesis.
Chest, 122 (2002), pp. 1018-1027
[50]
Putnam JB Jr, Walsh GL, Swisher SG, et al.
Outpatient management of malignant pleural effusion by a chronic indwelling pleural catheter.
Ann Thorac Surg, 69 (2000), pp. 369-375
[51]
López-Abente G, Hernández-Barrera V, Pollán M, et al.
Municipal pleural cancer mortality in Spain.
Occup Environ Med, 62 (2005), pp. 195-199
[52]
International Mesothelioma Interest Group.
A proposed new international TNM staging system for malignant pleural mesothelioma.
Chest, 108 (1995), pp. 1122-1128
[53]
Sugarbaker DJ, Flores RM, Jaklitsch MT, et al.
Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients.
J Thorac Cardiovasc Surg, 117 (1999), pp. 54-65
[54]
Vogelzang NJ, Rusthoven JJ, Symanowski J, et al.
Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma.
J Clin Oncol, 21 (2003), pp. 2636-2644
[55]
Enfermedades autoinmunes del tejido conectivo,
[56]
Ancochea Bermúdez J, Moldenhauer Díaz F, Espinosa de los Monteros MJ.
Manifestaciones pulmonares de las enfermedades del tejido conectivo.
Manual de Neumología y Cirugía Torácica, pp. 817-835
[57]
Keane MP, Lynch JP.
Pleuropulmonary manifestations of systemic lupus erythematosus.
Thorax, 55 (2000), pp. 159-166
[58]
Pertschuk LP, Moccia LF, Rosen Y, et al.
Acute pulmonary complications in systemic lupus erythematosus. Immunofluorescence and light microscopic study.
Am J Clin Pathol, 68 (1977), pp. 553-557
[60]
Lillington GA, Carr DT, Mayne JG.
Rheumatoid pleurisy with effusion.
Arch Intern Med, 128 (1971), pp. 764-768
[61]
Fernández C, Payá C, Hernández L, et al.
Rheumatoid factor: diagnostic utility in pleural fluid.
Eur Respir J, 22 (2003), pp. 191s
[62]
Naylor B.
The pathognomonic cytologic picture of rheumatoid pleuritis.
Acta Cytol, 34 (1990), pp. 465-473
[63]
Faurschou P, Francis D, Faarup P.
Thoracoscopic, histological, and clinical findings in nine cases of rheumatoid pleural effusion.
Thorax, 40 (1985), pp. 371-375
[64]
Romero-Candeira S, Fernández C, Martín C, et al.
Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure.
Am J Med, 110 (2001), pp. 681-686
[65]
Sadikot RT, Rogers JT, Cheng DS, et al.
Pleural fluid characteristics of patients with symptomatic pleural effusion after coronary artery bypass graft surgery.
Arch Intern Med, 160 (2000), pp. 2665-2668
[66]
Light RW, Rogers JT, Moyers JP, et al.
Prevalence and clinical course of pleural effusions at 30 days after coronary artery and cardiac surgery.
Am J Respir Crit Care Med, 166 (2002), pp. 1567-1571
[67]
Light RW.
Pleural effusions after coronary artery bypass graft surgery.
Curr Opin Pulm Med, 8 (2002), pp. 308-311
[68]
Tomaselli G, Gamsu G, Stulbarg MS.
Constrictive pericarditis presenting as pleural effusion of unknown origin.
Arch Intern Med, 149 (1989), pp. 201-203
[69]
Fernández C, Martínez S, Hernández L, et al.
Pleural effusion associated to constrictive pericarditis.
Eur Respir J, 26 (2005), pp. 446s-447s
[70]
Kim S, Sahn SA.
Postcardiac injury syndrome. An immunologic pleural fluid analysis.
Chest, 109 (1996), pp. 570-572
[71]
Stelzner TJ, King TE Jr, Antony VB, et al.
The pleuropulmonary manifestations of the postcardiac injury syndrome.
Chest, 84 (1983), pp. 383-387
[72]
Romero Candeira S, Hernández Blasco L, Soler MJ, et al.
Biochemical and cytologic characteristics of pleural effusions secondary to pulmonary embolism.
Chest, 121 (2002), pp. 465-469
[74]
Nielsen PH, Jepsen SB, Olsen AD.
Postoperative pleural effusion following upper abdominal surgery.
Chest, 96 (1989), pp. 1133-1135
[75]
Misawa Y, Fuso K, Kaegona T.
Infectious mediastinitis after cardiac operations: computed tomographic finding.
Ann Thorac Surg, 65 (1998), pp. 622-624
[76]
O'Brien J, Ettinger N.
Pulmonary complications of liver transplantation.
Clin Chest Med, 17 (1996), pp. 99-114
[77]
Ferrer J, Roldán J, Román A, et al.
Acute and chronic pleural complications in lung transplantation.
J Heart Lung Transplant, 22 (2003), pp. 1217-1225
[78]
Judson M, Handy J, Sahn S.
Pleural effusion from acute lung rejection.
Chest, 111 (1997), pp. 1128-1130
[79]
Alberts WM, Salem AJ, Solomon DA, et al.
Hepatic hydrothorax cause and management.
Arch Intern Med, 151 (1991), pp. 2383-2388
[80]
Pérez-Amor E, Almonacid C.
Derrame pleural en las enfermedades del aparato digestivo.
Rev Patol Respir, 6 (2003), pp. 57-64
[81]
Cárdenas A, Kelleher T, Chopra S.
Review article: hepatic hydrothorax.
Aliment Pharmacol Ther, 20 (2004), pp. 271-279
[82]
McKenna JM, Chandrasekhar Aj, Skorton D, et al.
The pleuropulmonary complications of pancreatitis.
Chest, 71 (1977), pp. 197-204
[83]
Huggins JT, Sahn SA.
Drug-induced pleural disease.
Clin Chest Med, 25 (2004), pp. 141-153
[84]
American Thoracic Society Documents.
Diagnosis, and Initial Management of Nonmalignant Diseases Related to Asbestos.
Am J Respir Crit Care Med, 170 (2004), pp. 691-715
[85]
Occupational Disorders of the Lung,
[86]
Dorigo O, Berek J.
Sex cord-stromal tumors of the ovary.
UpToDate, V12 (2004),
[87]
Insler V, Lunenfeld B.
Classification and treatment of ovarian hyperstimulation syndrome.
UpToDate, V12 (2004),
[89]
Romero S, Martín C, Hernández L, et al.
Chylothorax in cirrhosis of the liver: analysis of its frequency and clinical characteristics.
Chest, 114 (1998), pp. 154-159
[91]
Staats BA, Ellefson RW, Budahn LL, et al.
The lipoprotein profile of chylous and nonchylous pleural effusions.
Mayo Clin Proc, 55 (1980), pp. 700-704
[92]
González RP, Holevar MR.
Role of prophylactic antibiotics for tube thoracostomy in chest trauma.
Am Surg, 64 (1998), pp. 617-620
[93]
Luchette FA, Barrie PS, Oswanski MF, et al.
Practice management guidelines for prophylactic antibiotic use in tube thoracostomy for traumatic hemopneumothorax: the EAST Practice Management Guidelines Work Group. Eastern Association for Trauma.
J Trauma, 48 (2000), pp. 753-757
[94]
Ahmed N, Jones D.
Video-assisted thoracic surgery: state of the art in trauma care.
Injury, 35 (2004), pp. 479-489
[95]
Jerjes-Sánchez C, Ramírez-Rivera A, Elizalde JJ, et al.
Intrapleural fibrinolysis with streptokinase as an adjunctive treatment in hemothorax and empyema: a multicenter trial.
Chest, 109 (1996), pp. 1514-1519
[96]
Meyer DM, Jessen ME, Wait MA, et al.
Early evacuation of traumatic retained hemothoraces using thoracoscopy: a prospective, randomized trial.
Ann Thorac Surg, 64 (1997), pp. 1396-1400
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