Abstract
Chest physiotherapy (CPT) is widely used in cases of pleural effusion treated by chest drainage but there are few data about which approach is effective.
Hypothesis: The non-invasive positive pressure accelerates the reabsorption of pleural effusion.
Aim: To test the effects of non-invasive positive airway pressure added to CPT on resolution of pleural effusions after drainage.
Methods: This trial enrolled 43 patients with pleural effusion and chest drainage in situ for <24h randomly assignedinto 3 groups: I=Positive Pressure at 15cmH2O + CPT (n=14), II=Chest Physiotherapy (n=17) and III=Control (sham intervention, n=12). All patients received 3 daily interventions until the drain remove is up to a maximum of 7 days. Lung function, chest drainage output and X-ray (criteria for removal of drain=output over 24h ≤200ml + full lung expansion on X-ray) were daily assessed. Days of chest tube drainage, length of hospital stay, pulmonary complications (pneumonia, atelectasis or severe hypoxemia) were recorded until discharge. Outcome assessors and statisticians were blinded to the random allocation. ANOVA, Kaplan-Meier and chi-square were tested considering intention to treat.
Results: Group I presented shorter chest tube drainage and hospital stay of 2 days (p<0.05) compared to Groups II and III. In addition, Group I had decreased need for antibiotic and a faster recovery of pulmonary volumes (p<0.05); however, with similar rate of pulmonary complications to the other groups.
Conclusion: Non-invasive positive airway pressure added to conventional CPT promotes a faster resolution of pleural effusion in patients with chest drainage.
- Copyright ©ERS 2015