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Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2020.0081    [Accepted]
Published online November 9, 2020.
Pleural Space Elastance And Its Relation to Success Rates of Pleurodesis In Malignant Pleural Effusion
Hossam Hosny Masoud, , Mahmoud Mohamed El-Zorkany, , Azza Anwar Ahmed, , Hebatallah Hany Assal,
Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo
Correspondence:  Hebatallah Hany Assal, Tel: 00201223939861, 
Email: Hebatallah.Assal@kasralainy.edu.eg
Received: 23 July 2020   • Revised: 28 September 2020   • Accepted: 9 November 2020
Abstract
Introduction
Pleurodesis fails in 10–40% of patients with recurrent malignant pleural effusions MPEs and dyspnea.
Aim of study
The aim of the current study was to assess the values of pleural elastance after aspiration of 500 ml of pleural fluid and its relation to pleurodesis outcome, also to compare the pleurodesis outcome with chemical characteristics of pleural fluid.
Methods
A prospective study was conducted in Kasr El-Aini hospital, Cairo University in the period from March 2019 to January 2020. It was carried on 40 patients with malignant pleural effusion. Measurement of pleural elastance after aspiration of 500 ml of fluid was done "PEL 0.5" (cm H2O/L) as well as studying the characteristics of the pleural fluid chemically and cytologically. Pleurodesis was done and the patients were evaluated after 1 month. Pleural elastance was compared with pleurodesis outcome.
Results
After 4 weeks follow up, the success rate of pleurodesis was 65%. In failed pleurodesis, the PEL 0.5 was significantly higher than successful pleurodesis. A cutoff point of PEL 0.5 > 14.5 cm H2O/L was associated with failure of pleurodesis with a sensitivity and specificity of 93% and 100% respectively. The patients with failed pleurodesis had significant lower PH level in fluid than successful group (P < 0.001).
Conclusion
Pleural elastance measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for failure of pleurodesis in patients with malignant pleural effusion.
Key Words: Pleural elastance, Malignant pleural effusion, Pleurodesis


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