Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 02-109, Warsaw, Poland.
Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-097, Warsaw, Poland.
Sci Rep. 2022 Jul 7;12(1):11502. doi: 10.1038/s41598-022-15480-4.
Cough during therapeutic thoracentesis (TT) is considered an adverse effect. The study was aimed to evaluate the relationship between cough during TT and pleural pressure (Ppl) changes (∆P). Instantaneous Ppl was measured after withdrawal of predetermined volumes of pleural fluid. Fluid withdrawal (FW) and Ppl measurement (PplM) periods were analyzed separately using the two sample Kolmogorov-Smirnov test and the nonparametric skew to assess differences between ∆P distributions in periods with and without cough. The study involved 59 patients, median age 66 years, median withdrawn fluid volume 1800 mL (1330 ÷ 2400 mL). In total, 1265 cough episodes were recorded in 52 patients, in 24% of FW and 19% of PplM periods, respectively. Cough was associated with significant changes in ∆P distribution (p < 0.001), decreasing the left tail of ∆P distribution for FW periods (the skew = - 0.033 vs. - 0.182) and increasing the right tail for PplM periods (the skew = 0.182 vs. 0.088). Although cough was more frequent in 46 patients with normal pleural elastance (p < 0.0001), it was associated with significantly higher ∆P in patients with elevated elastance (median Ppl increase 2.9 vs. 0.2 cmHO, respectively). Cough during TT is associated with small but beneficial trend in Ppl changes, particularly in patients with elevated pleural elastance, and should not be considered solely as an adverse event.
在治疗性胸腔穿刺术（TT）期间咳嗽被认为是一种不良反应。本研究旨在评估 TT 期间咳嗽与胸腔内压力（Ppl）变化（∆P）之间的关系。在抽出预定量的胸腔积液后立即测量即时 Ppl。分别使用两个样本的 Kolmogorov-Smirnov 检验和非参数偏度来分析液体抽取（FW）和 Ppl 测量（PplM）期间，以评估有咳嗽和无咳嗽期间 ∆P 分布之间的差异。该研究纳入了 59 名患者，中位年龄为 66 岁，中位抽出的液体量为 1800 毫升（1330÷2400 毫升）。在 52 名患者中总共记录了 1265 次咳嗽发作，分别占 FW 期的 24%和 PplM 期的 19%。咳嗽与 ∆P 分布的显著变化相关（p<0.001），减少 FW 期 ∆P 分布的左尾（偏度=-0.033 对-0.182），增加 PplM 期的右尾（偏度=0.182 对 0.088）。尽管在正常胸膜弹性的 46 名患者中咳嗽更为频繁（p<0.0001），但它与胸膜弹性升高的患者显著更高的 ∆P 相关（中位 Ppl 增加分别为 2.9 和 0.2cmH2O）。TT 期间的咳嗽与 Ppl 变化的小但有益的趋势相关，尤其是在胸膜弹性升高的患者中，不应仅将其视为不良事件。
