Original Articles
Changes in the Acid-Base Equilibrium of Pleural Fluid During the First 2 Hours After Thoracentesis
M. Haro-Estarriola,
, X. Baldó-Padrób, M. Lora-Díeza, M. Rubio-Garayb, M. Rubio-Godaya, F. Sebastián-Quetglásb
Corresponding author
mip.mharo@htrueta.scs.es
Correspondence: Dr. M. Haro-Estarriol. Sección de Neumología. Planta 4.a B. Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona. España
Correspondence: Dr. M. Haro-Estarriol. Sección de Neumología. Planta 4.a B. Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona. España
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"apellidos" => "Haro-Estarriol" "email" => array:1 [ 0 => "mip.mharo@htrueta.scs.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "X." "apellidos" => "Baldó-Padró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Lora-Díez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Rubio-Garay" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "Rubio-Goday" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "F." "apellidos" => "Sebastián-Quetglás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Neumología, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. M. Haro-Estarriol. Sección de Neumología. Planta 4.<span class="elsevierStyleSup">a</span> B. Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-01-10" "fechaAceptado" => "2005-04-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153773" "palabras" => array:5 [ 0 => "Pleural fluid" 1 => "pH" 2 => "PO<span class="elsevierStyleInf">2</span>" 3 => "PCO<span class="elsevierStyleInf">2</span>" 4 => "Effect of time" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153774" "palabras" => array:5 [ 0 => "Líquido pleural" 1 => "pH" 2 => "PO<span class="elsevierStyleInf">2</span>" 3 => "PCO<span class="elsevierStyleInf">2</span>" 4 => "Efecto del tiempo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to assess changes in the acid-base equilibrium of pleural fluid during the first 2 hours after thoracentesis and to determine whether, as with arterial blood, it is important to keep the fluid on ice.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A prospective, descriptive, comparative study was performed in 53 consecutive patients with pleural effusion. Thoracentesis was performed and pleural fluid was collected in 5 heparinized syringes to determine the pH, PO<span class="elsevierStyleInf">2</span>, and PCO<span class="elsevierStyleInf">2</span> at baseline and at 30, 60, 90, and 120 minutes. In the first 26 patients, pleural fluid was collected in a further 4 syringes that were kept on ice prior to performing the same measurements at 30, 60, 90, and 120 minutes.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The patients had a mean (SD) age of 70 (14) years, 66% were smokers, 72% were men, 63% had right-sided pleural effusion, 85% had unilateral effusion, and 15% had massive effusion. In 10 patients the effusion was a transudate, in 35 it was lymphocytic, and in 8 it was neutrophilic. The etiology was benign in 34 cases and neoplastic in 19 cases. The baseline pH was 7.35 (0.1) and baseline values of PO<span class="elsevierStyleInf">2</span> and PCO<span class="elsevierStyleInf">2</span> were 57.8 (20) mm Hg and 53.7 (15) mm Hg, respectively. No significant changes were observed in the first 2 hours for either pH or PCO<span class="elsevierStyleInf">2</span>, whereas PO<span class="elsevierStyleInf">2</span> did undergo a significant change over this period. The difference between the baseline value and the value obtained at 120 minutes was 0.005 (0.02) for pH, 12.5 (19) mm Hg for PO<span class="elsevierStyleInf">2</span>, and 0.8 (3) mm Hg for PCO<span class="elsevierStyleInf">2</span>, with correlation coefficients of 0.97, 0.49, and 0.98, respectively. Comparison of values by simple regression analysis did not reveal a significant difference in the changes in pH, PO<span class="elsevierStyleInf">2</span>, or PCO<span class="elsevierStyleInf">2</span> associated with keeping samples on ice. Multivariate analysis revealed that neoplastic effusion and a higher red blood cell count in pleural fluid had a significant influence on pH changes.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The pH and PCO<span class="elsevierStyleInf">2</span> of pleural fluid did not change significantly during the first 2 hours following thoracentesis, whereas PO<span class="elsevierStyleInf">2</span> did undergo a significant change. Keeping samples on ice during this period is unnecessary. Only a higher red blood cell count in pleural fluid and neoplastic effusion had a limited effect on changes in the pH of samples from our patients during the first 2 hours following thoracentesis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar los cambios en el equilibrio ácido-base del líquido pleural durante las primeras 2 h de la toracocentesis y la importancia de su conservación en hielo como ocu-rre en la sangre arterial.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo, descriptivo y comparativo de 53 pacientes consecutivos con un derrame pleural. Se realizó toracocentesis con extracción del líquido pleural en 5 jeringas heparinizadas para determinar el pH, presión arterial de oxígeno (PO<span class="elsevierStyleInf">2</span>) y de anhídrido carbónico (PCO<span class="elsevierStyleInf">2</span>) basales, a los 30, 60, 90 y 120 min. En los primeros 26 pacientes se obtuvieron 4 jeringas que se conservaron en hielo y se realizaron las mismas determinaciones en el tiempo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">LOS pacientes tenían una edad media (± des-viación estándar) de 70 ± 14 años, el 66% eran fumadores, el 72% varones, un 63% tenía un derrame derecho, un 85% unilateral y el 15% masivo. En 10 casos era un trasudado, en 35 exudado linfocitario y en 8 neutrofílico. La etiología fue benigna en 34 casos y neoplásica en 19. El valor basal del pH fue de 7,35 ± 0,1, y los de PO<span class="elsevierStyleInf">2</span>y PCO<span class="elsevierStyleInf">2</span> de 57,8 ± 20 y 53,7 ± 15 mmHg, respectivamente, y no presentaron cambios significativos durante las primeras 2 h, a excepción de la PO<span class="elsevierStyleInf">2</span>. El pH presentó una diferencia entre su valor basal y a los 120 min de 0,005 ± 0,02, la PO<span class="elsevierStyleInf">2</span> de 12,5 ± 19 mmHg y la PCO<span class="elsevierStyleInf">2</span> de 0,8 ± 3 mmHg, con unos coeficientes de correlación de 0,97, 0,49 y 0,98, respectivamente. El estudio comparativo y la regresión simple no demostraron una influencia sig-nificativa de la conservación en hielo en los cambios de pH, PO<span class="elsevierStyleInf">2</span> o PCO<span class="elsevierStyleInf">2</span>. Una etiología neoplásica y un mayor número de hematíes influyeron de forma significativa en los cambios de pH en el análisis multivariante.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El pH y la PCO<span class="elsevierStyleInf">2</span> pleurales no presentaron cambios significativos durante las primeras 2 h de la toracocentesis, a diferencia de la PO<span class="elsevierStyleInf">2</span>. La conservación en hielo no estaría indicada durante este período. Sólo un nümero más elevado de hematíes o una etiología neoplásica tuvieron una influencia limitada en los cambios de los valores del pH de nuestros pacientes en las primeras 2 h.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pleural effusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "RW Light" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "25" "paginaInicial" => "1971" "paginaFinal" => "1977" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿De qué nos informa el líquido pleural?" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 27 | 20 | 47 |
| 2024 September | 28 | 20 | 48 |
| 2024 August | 38 | 31 | 69 |
| 2024 July | 27 | 31 | 58 |
| 2024 June | 39 | 23 | 62 |
| 2024 May | 37 | 30 | 67 |
| 2024 April | 17 | 30 | 47 |
| 2024 March | 20 | 20 | 40 |
| 2024 February | 19 | 18 | 37 |
| 2023 March | 1 | 0 | 1 |
| 2023 February | 16 | 23 | 39 |
| 2023 January | 15 | 23 | 38 |
| 2022 December | 17 | 21 | 38 |
| 2022 November | 21 | 18 | 39 |
| 2022 October | 19 | 37 | 56 |
| 2022 September | 21 | 19 | 40 |
| 2022 August | 18 | 31 | 49 |
| 2022 July | 17 | 38 | 55 |
| 2022 June | 14 | 29 | 43 |
| 2022 May | 14 | 34 | 48 |
| 2022 April | 18 | 31 | 49 |
| 2022 March | 15 | 28 | 43 |
| 2022 February | 23 | 31 | 54 |
| 2022 January | 13 | 37 | 50 |
| 2021 December | 20 | 55 | 75 |
| 2021 November | 12 | 39 | 51 |
| 2021 October | 15 | 42 | 57 |
| 2021 September | 19 | 40 | 59 |
| 2021 August | 13 | 23 | 36 |
| 2021 July | 8 | 24 | 32 |
| 2021 June | 16 | 29 | 45 |
| 2021 May | 13 | 25 | 38 |
| 2021 April | 43 | 52 | 95 |
| 2021 March | 21 | 16 | 37 |
| 2021 February | 13 | 27 | 40 |
| 2021 January | 11 | 15 | 26 |
| 2020 December | 8 | 14 | 22 |
| 2020 November | 8 | 9 | 17 |
| 2020 October | 10 | 7 | 17 |
| 2020 September | 12 | 3 | 15 |
| 2020 August | 13 | 9 | 22 |
| 2020 July | 12 | 16 | 28 |
| 2020 June | 9 | 12 | 21 |
| 2020 May | 27 | 25 | 52 |
| 2020 April | 14 | 10 | 24 |
| 2020 March | 11 | 15 | 26 |
| 2020 February | 56 | 12 | 68 |
| 2020 January | 54 | 10 | 64 |
| 2019 December | 10 | 14 | 24 |
| 2019 November | 10 | 15 | 25 |
| 2019 October | 7 | 23 | 30 |
| 2019 September | 33 | 14 | 47 |
| 2019 August | 15 | 17 | 32 |
| 2019 July | 17 | 22 | 39 |
| 2019 June | 21 | 11 | 32 |
| 2019 May | 38 | 16 | 54 |
| 2019 April | 53 | 48 | 101 |
| 2019 March | 19 | 24 | 43 |
| 2019 February | 14 | 11 | 25 |
| 2019 January | 13 | 18 | 31 |
| 2018 December | 9 | 18 | 27 |
| 2018 November | 14 | 10 | 24 |
| 2018 October | 19 | 17 | 36 |
| 2018 September | 10 | 10 | 20 |
| 2018 May | 9 | 1 | 10 |
| 2018 April | 7 | 12 | 19 |
| 2018 March | 1 | 6 | 7 |
| 2018 February | 4 | 9 | 13 |
| 2018 January | 3 | 7 | 10 |
| 2017 December | 4 | 9 | 13 |
| 2017 November | 5 | 7 | 12 |
| 2017 October | 5 | 8 | 13 |
| 2017 September | 4 | 10 | 14 |
| 2017 August | 5 | 21 | 26 |
| 2017 July | 1 | 4 | 5 |
| 2017 June | 10 | 29 | 39 |
| 2017 May | 3 | 17 | 20 |
| 2017 April | 3 | 10 | 13 |
| 2017 March | 3 | 11 | 14 |
| 2017 February | 0 | 1 | 1 |
| 2017 January | 2 | 6 | 8 |
| 2016 December | 9 | 7 | 16 |
| 2016 November | 16 | 11 | 27 |
| 2016 October | 9 | 13 | 22 |
| 2016 September | 5 | 15 | 20 |
| 2016 August | 7 | 6 | 13 |
| 2016 July | 0 | 5 | 5 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 78 | 19 | 97 |
| 2015 September | 83 | 15 | 98 |
| 2015 August | 81 | 9 | 90 |
| 2015 July | 143 | 18 | 161 |
| 2015 June | 77 | 12 | 89 |
| 2015 May | 79 | 15 | 94 |
| 2015 April | 77 | 15 | 92 |
| 2015 March | 68 | 10 | 78 |
| 2015 February | 82 | 9 | 91 |
| 2015 January | 55 | 10 | 65 |
| 2014 December | 70 | 15 | 85 |
| 2014 November | 83 | 22 | 105 |
| 2014 October | 84 | 16 | 100 |
| 2014 September | 78 | 12 | 90 |
| 2014 August | 65 | 17 | 82 |
| 2014 July | 68 | 20 | 88 |
| 2014 June | 66 | 13 | 79 |
| 2014 May | 69 | 12 | 81 |
| 2014 April | 80 | 13 | 93 |
| 2014 March | 73 | 14 | 87 |
| 2014 February | 51 | 13 | 64 |
| 2014 January | 41 | 7 | 48 |
| 2013 December | 46 | 11 | 57 |
| 2013 November | 34 | 8 | 42 |
| 2013 October | 41 | 19 | 60 |
| 2013 September | 31 | 11 | 42 |
| 2013 August | 41 | 9 | 50 |
| 2013 July | 46 | 22 | 68 |
| 2013 June | 37 | 7 | 44 |
| 2013 May | 38 | 16 | 54 |
| 2013 April | 35 | 12 | 47 |
| 2013 March | 6 | 1 | 7 |
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