Comparison of pleural pressure measuring instruments

Hans J. Lee, Lonny Yarmus, David Kidd, Ricardo Ortiz, Jason Akulian, Christopher Gilbert, Andrew Hughes, Richard E. Thompson, Sixto Arias, David Feller-Kopman

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The objective of this study was to compare the accuracy of a handheld digital manometer (DM) and U-tube (UT) manometer with an electronic transducer (ET) manometer during thoracentesis.

METHODS: Th irty-three consecutive patients undergoing thoracentesis were enrolled in the study. Pleural pressure (Ppl) measurements were made using a handheld DM (Compass; Mirador Biomedical), a UT water manometer, and an ET (reference instrument). End-expiratory Ppl was recorded aft er catheter insertion, aft er each aspiration of 240 mL, and prior to catheter removal. Volume of fluid removed, symptoms during thoracentesis, pleural elastance, and pleural fluid chemistry were also evaluated.

RESULTS: A total of 594 Ppl measurements were made in 30 patients during their thoracenteses. There was a strong linear correlation coefficient between elastance for the DM and ET ( r 5 0.9582, P < .001). Correlation was poor between the UT and ET ( r = 0.0448, P = .84). Among the 15 patients who developed cough, recorded ET pressures ranged from -9 to + 9 cm H 2 O at the time of symptom development, with a mean (SD) of - 2.93 (4.89) cm H 2 O. ET and DM measurements among those patients with cough had a low correlation between these measurements (R 2 = 0.104, P = .24). Nine patients developed chest discomfort and had ET pressures that ranged from - 26 to + 6 cm H 2 O, with a mean (SD) of - 7.89 (9.97) cm H 2 O.

CONCLUSIONS: The handheld DM provided a valid and easy-to-use method to measure Ppl during thoracentesis. Future studies are needed to investigate its usefulness in predicting clinically meaningful outcomes.

Original languageEnglish (US)
Pages (from-to)1007-1012
Number of pages6
JournalCHEST
Volume146
Issue number4
DOIs
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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