Assessment of pleural pressure in the evaluation of pleural effusions
Feller-Kopman D., Parker MJ., Schwartzstein RM.
Pleural manometry provides data to enhance our understanding of the underlying pleural pathophysiology when an effusion is present and aids the physician in both diagnostic and therapeutic decisions. The measurement of pleural pressure helps to differentiate lung entrapment and trapped lung, allows for the safe removal of large effusions, and is a useful tool to select appropriate patients with malignant pleural effusions for pleurodesis. If formal manometry is not performed during thoracentesis, the symptom of a vague chest discomfort can be used as a surrogate for potentially dangerous drops in pleural pressure and should prompt the termination of thoracentesis, even if fluid remains in the chest. Copyright © 2009 American College of Chest Physicians.