Pulmonary consolidation alters the ultrasound estimate of pleural fluid volume when considering chest drainage in patients on ECMO

• Published in: Critical care (London, England) England), 2022-05, Vol.26 (1), p.144-144, Article 144
• Main Authors: Balik, Martin, Mokotedi, Masego Candy, Maly, Michal, Otahal, Michal, Stach, Zdenek, Svobodova, Eva, Flaksa, Marek, Rulisek, Jan, Brozek, Tomas, Porizka, Michal
• Format: Article
• Language: English
• Subjects: Biopsy; Blood oxygenation, Extracorporeal; Correspondence; Critical care; Drainage; Drainage, Surgical; Extracorporeal Membrane Oxygenation; Humans; Lungs; Methods; Planning; Pleura; Pleural Effusion - diagnostic imaging; Pleural Effusion - therapy; Respiratory System; Ultrasonic imaging; Ultrasonography; Ventilators
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-022-04018-9

After excluding three effusions (5.7%) for incomplete drainage, a total of 50 effusions were evaluated and drained in 42 (27 males and 15 females) patients (age 44 ± 17 years, APACHE II 25.8 ± 6.8, SOFA 11 ± 2.5, height 174 ± 7 cm, body weight 87 ± 20 kg). The known CUS assessment of pleural fluid volume largely underestimates reality [1] in severely consolidated lungs surrounded by potentially misleadingly thin layer of circumferential effusion. The prediction error may be greatly reduced by calculating with pleural separation above the posterior axillary line which enables better evaluation of the benefits of pleural drainage versus the risks of complications in anticoagulated patients on ECMO (Fig. 1).