Original Articles
Influence of the Method Used to Obtain Pleural Fluid on the Determination of the Acid-Base Balance
Manuel Haro-Estarriol
, Juan Carlos Calderón-López, Gladis Sabater-Talaverano, Núria Font Vall-Llobera, Luis Alberto Álvarez-Castillo, Salvi Sendra-Salillas
Corresponding author
mip.mharo@htrueta.scs.es
Correspondence: Dr M. Haro-Estarriol Servicio de Neumología (Planta 4.ª B) Hospital Universitario de Girona Dr Josep Trueta Avda. de Francia, s/n 17007 Girona, Spain
Correspondence: Dr M. Haro-Estarriol Servicio de Neumología (Planta 4.ª B) Hospital Universitario de Girona Dr Josep Trueta Avda. de Francia, s/n 17007 Girona, Spain
Servicio de Neumología, Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain
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Haro-Estarriol Servicio de Neumología (Planta 4.ª B) Hospital Universitario de Girona Dr Josep Trueta Avda. de Francia, s/n 17007 Girona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-07-27" "fechaAceptado" => "2007-10-31" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155343" "palabras" => array:3 [ 0 => "Pleural effusion" 1 => "pH" 2 => "Thoracentesis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155342" "palabras" => array:3 [ 0 => "Derrame pleural" 1 => "pH" 2 => "Toracocentesis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To analyze the methods used in our hospital for obtaining pleural fluid to determine the acid-base balance and to evaluate the clinical repercussions of each method.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Initially we studied the methods used by physicians in our hospital to collect pleural fluid for determination of the acid-base balance. In a second phase, we performed a prospective, descriptive, comparative study with the participation of 71 patients with pleural effusions in order to compare the acid-base balance according to the technique used to obtain the fluid.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Pleural fluid was obtained using 3 methods: <span class="elsevierStyleItalic">a)</span> direct extraction using a heparinized syringe (group 1); <span class="elsevierStyleItalic">b)</span> extraction using a 20-mL syringe with subsequent aspiration from this syringe into a heparinized syringe (group 2); and <span class="elsevierStyleItalic">c)</span> filling a heparinized syringe from the 20- mL syringe (group 3). The only significant differences between group 1 and groups 2 and 3 were an increase in the pleural PO<span class="elsevierStyleInf">2</span> and oxygen saturation. The difference in the mean pH between groups 1 and 2 was 0.009 (95% confidence interval: −0.39 to 0.02; <span class="elsevierStyleItalic">P</span>=.5) and between groups 1 and 3 was 0.007 (95% confidence interval: −0.38 to 0.023; <span class="elsevierStyleItalic">P</span>=.6). The correlations between findings for PO<span class="elsevierStyleInf">2</span>, pH, and PCO<span class="elsevierStyleInf">2</span> obtained in the different groups were statistically significant, with values superior to .95 in the last 2 variables.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Physicians who perform thoracentesis in our hospital use different methods for obtaining fluid to determine the pleural acid-base balance. The 3 methods analyzed show no significant differences with regard to pH or PCO<span class="elsevierStyleInf">2</span>. Pleural fluid may be obtained by a single puncture with a large-volume syringe, subsequently transferring the fluid to a heparinized syringe without this significantly affecting the pH or PCO<span class="elsevierStyleInf">2</span>, thus reducing the number of manipulations and the risk of complications.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar las formas de obtención del líquido para determinar el equilibrio ácido-base pleural en nuestro medio y su influencia o relevancia clínica.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">En una primera fase se describieron las formas en que los médicos de nuestro hospital obtenían el líquido para determinar el equilibrio ácido-base pleural. En una segunda fase se realizó un estudio prospectivo, descriptivo y comparativo de 71 pacientes con derrame para comparar el equilibrio ácido-base pleural según las formas de obtención.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El líquido pleural se obtenía de 3 formas distintas: <span class="elsevierStyleItalic">a)</span> extracción directa con jeringa heparinizada (grupo I); <span class="elsevierStyleItalic">b)</span> extracción con jeringa de 20 ml, aspirando de esta jeringa con la jeringa heparinizada (grupo II), o <span class="elsevierStyleItalic">c)</span> llenando la jeringa heparinizada con la jeringa de 20 ml (grupo III). Se observó un aumento significativo sólo en los valores de la presión parcial (PO<span class="elsevierStyleInf">2</span>) y saturación de oxígeno entre el grupo I y los grupos II o III. La diferencia de las medias del pH entre los grupos I y II fue de 0,009 (intervalo de confianza del 95%, −0,039 a 0,02; p = 0,5), y entre los grupos I y III, de 0,007 (intervalo de confianza del 95%, −0,038 a 0,023; p = 0,6). Las correlaciones entre los distintos grupos de la PO<span class="elsevierStyleInf">2</span>, pH y presión parcial de anhídrido carbónico (PCO<span class="elsevierStyleInf">2</span>) fueron estadísticamente significativas y con valores superiores a 0,95 en las 2 últimas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los médicos que realizan las toracocentesis en nuestro hospital procesan de formas distintas el líquido para determinar el equilibrio ácido-base pleural. Las 3 formas analizadas no mostraron diferencias significativas en cuanto al pH y la PCO<span class="elsevierStyleInf">2</span>. La obtención del líquido puede realizarse con una única punción con jeringas de mayor capacidad, para posteriormente llenar la jeringa heparinizada, sin que se modifiquen de forma significativa los valores del pH y la PCO<span class="elsevierStyleInf">2</span>, y con una disminución del número de manipulaciones y el riesgo de complicaciones.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:23 [ 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 | 1 | 1 | 2 |
| 2024 October | 28 | 33 | 61 |
| 2024 September | 27 | 21 | 48 |
| 2024 August | 38 | 55 | 93 |
| 2024 July | 29 | 24 | 53 |
| 2024 June | 35 | 31 | 66 |
| 2024 May | 35 | 31 | 66 |
| 2024 April | 21 | 24 | 45 |
| 2024 March | 24 | 18 | 42 |
| 2024 February | 34 | 18 | 52 |
| 2023 March | 7 | 3 | 10 |
| 2023 February | 20 | 26 | 46 |
| 2023 January | 18 | 24 | 42 |
| 2022 December | 18 | 28 | 46 |
| 2022 November | 15 | 42 | 57 |
| 2022 October | 24 | 28 | 52 |
| 2022 September | 16 | 18 | 34 |
| 2022 August | 22 | 37 | 59 |
| 2022 July | 24 | 45 | 69 |
| 2022 June | 19 | 31 | 50 |
| 2022 May | 18 | 29 | 47 |
| 2022 April | 20 | 40 | 60 |
| 2022 March | 19 | 37 | 56 |
| 2022 February | 19 | 30 | 49 |
| 2022 January | 15 | 28 | 43 |
| 2021 December | 22 | 51 | 73 |
| 2021 November | 21 | 50 | 71 |
| 2021 October | 25 | 47 | 72 |
| 2021 September | 20 | 61 | 81 |
| 2021 August | 9 | 35 | 44 |
| 2021 July | 12 | 26 | 38 |
| 2021 June | 17 | 33 | 50 |
| 2021 May | 15 | 30 | 45 |
| 2021 April | 35 | 64 | 99 |
| 2021 March | 41 | 21 | 62 |
| 2021 February | 19 | 23 | 42 |
| 2021 January | 10 | 16 | 26 |
| 2020 December | 22 | 16 | 38 |
| 2020 November | 16 | 15 | 31 |
| 2020 October | 14 | 15 | 29 |
| 2020 September | 6 | 6 | 12 |
| 2020 August | 11 | 10 | 21 |
| 2020 July | 15 | 24 | 39 |
| 2020 June | 10 | 1 | 11 |
| 2020 May | 12 | 18 | 30 |
| 2020 April | 19 | 21 | 40 |
| 2020 March | 22 | 15 | 37 |
| 2020 February | 17 | 12 | 29 |
| 2020 January | 19 | 16 | 35 |
| 2019 December | 22 | 14 | 36 |
| 2019 November | 12 | 13 | 25 |
| 2019 October | 8 | 12 | 20 |
| 2019 September | 4 | 9 | 13 |
| 2019 August | 12 | 8 | 20 |
| 2019 July | 10 | 16 | 26 |
| 2019 June | 9 | 9 | 18 |
| 2019 May | 13 | 12 | 25 |
| 2019 April | 24 | 15 | 39 |
| 2019 March | 18 | 16 | 34 |
| 2019 February | 14 | 21 | 35 |
| 2019 January | 11 | 13 | 24 |
| 2018 December | 19 | 13 | 32 |
| 2018 November | 19 | 18 | 37 |
| 2018 October | 19 | 13 | 32 |
| 2018 September | 10 | 7 | 17 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 16 | 5 | 21 |
| 2018 March | 7 | 7 | 14 |
| 2018 February | 8 | 6 | 14 |
| 2018 January | 7 | 9 | 16 |
| 2017 December | 11 | 9 | 20 |
| 2017 November | 3 | 4 | 7 |
| 2017 October | 9 | 9 | 18 |
| 2017 September | 3 | 5 | 8 |
| 2017 August | 6 | 10 | 16 |
| 2017 July | 11 | 11 | 22 |
| 2017 June | 8 | 12 | 20 |
| 2017 May | 5 | 7 | 12 |
| 2017 April | 1 | 3 | 4 |
| 2017 March | 8 | 56 | 64 |
| 2017 February | 8 | 6 | 14 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 15 | 7 | 22 |
| 2016 November | 10 | 8 | 18 |
| 2016 October | 17 | 11 | 28 |
| 2016 September | 14 | 5 | 19 |
| 2016 August | 13 | 5 | 18 |
| 2016 July | 11 | 3 | 14 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 45 | 19 | 64 |
| 2015 September | 46 | 18 | 64 |
| 2015 August | 31 | 17 | 48 |
| 2015 July | 34 | 5 | 39 |
| 2015 June | 32 | 7 | 39 |
| 2015 May | 50 | 10 | 60 |
| 2015 April | 27 | 8 | 35 |
| 2015 March | 28 | 3 | 31 |
| 2015 February | 33 | 5 | 38 |
| 2015 January | 35 | 5 | 40 |
| 2014 December | 63 | 7 | 70 |
| 2014 November | 32 | 9 | 41 |
| 2014 October | 48 | 8 | 56 |
| 2014 September | 30 | 4 | 34 |
| 2014 August | 43 | 11 | 54 |
| 2014 July | 40 | 7 | 47 |
| 2014 June | 56 | 8 | 64 |
| 2014 May | 46 | 10 | 56 |
| 2014 April | 52 | 10 | 62 |
| 2014 March | 61 | 10 | 71 |
| 2014 February | 46 | 8 | 54 |
| 2014 January | 48 | 5 | 53 |
| 2013 December | 35 | 13 | 48 |
| 2013 November | 33 | 7 | 40 |
| 2013 October | 36 | 7 | 43 |
| 2013 September | 30 | 9 | 39 |
| 2013 August | 49 | 9 | 58 |
| 2013 July | 47 | 11 | 58 |
| 2013 June | 25 | 10 | 35 |
| 2013 May | 45 | 8 | 53 |
| 2013 April | 17 | 9 | 26 |
| 2013 March | 7 | 2 | 9 |
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