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Semin Respir Crit Care Med 2023; 44(04): 502-508
DOI: 10.1055/s-0043-1769098
Review Article

Breathlessness with Pleural Effusion: What Do We Know?

Sanjeevan Muruganandan
1   Department of Respiratory Medicine, The Northern Hospital, Melbourne, Australia
2   School of Medicine, Health Sciences, Dentistry, University of Melbourne, Melbourne, Australia
,
Eleanor Mishra
3   Norwice Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
4   Norwice Medical School, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, Norfolk, United Kingdom
,
Bhajan Singh
5   Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Australia
6   School of Human Sciences, University of Western Australia, Perth, Australia
7   West Australian Sleep Disorders Research Institute, Perth, Australia
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Abstract

Breathlessness is the most common symptom in individuals with pleural effusion and is often disabling. The pathophysiology of breathlessness associated with pleural effusion is complex. The severity of breathlessness correlates weakly with the size of the effusion. Improvements in ventilatory capacity following pleural drainage are small and correlate poorly with the volume of fluid drained and improvements in breathlessness. Impaired hemidiaphragm function and a compensatory increase in respiratory drive to maintain ventilation appear to be an important mechanism of breathlessness associated with pleural effusion. Thoracocentesis reduces diaphragm distortion and improves its movement; these changes appear to reduce respiratory drive and associated breathlessness by improving the neuromechanical efficiency of the diaphragm.

Keywords

dyspnea - breathlessness - pleural effusion - ultrasonography - VAS - diaphragm


Publikationsverlauf

Artikel online veröffentlicht:
12. Juni 2023

© 2023. Thieme. All rights reserved.

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