Thorac Cardiovasc Surg 2006; 54(7): 493-497
DOI: 10.1055/s-2006-924249
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Can Intrapleural C-Reactive Protein Predict VATS Pleurodesis Failure?

F. Leo1 , N. Vénissac1 , D. Pop1 , A. Rosenthal-Allieri2 , J. Mouroux1
  • 1Thoracic Surgery Department, Pasteur Hospital, University Hospital of Nice, Nice, France
  • 2Immunology Department, Pasteur Hospital, University Hospital of Nice, Nice, France
Further Information

Publication History

Received January 9, 2006

Publication Date:
06 November 2006 (online)

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Abstract

Background: Intrapleural inflammatory reaction after surgery for spontaneous pneumothorax is a key indicator whether an effective pleurodesis has been achieved. In this study, we tested the hypothesis that intrapleural C-reactive protein (CRP) might precisely quantify the postoperative pleural inflammation, offering potentially useful information for patient management. Methods: The study population consisted of 75 consecutive patients who underwent video-assisted thoracoscopic pleurectomy or pleural abrasion for spontaneous pneumothorax between April 2003 and August 2004. We assessed CRP levels in pleural and blood samples taken daily in the first 4 postoperative days. Results: Intrapleural CRP profile was significantly lower in patients who underwent pleural abrasion, in younger patients (< 25 years) and in patients who were not drained before surgery. Patients with pleurodesis failure had a lower CRP peak with a delayed peak. Receiving operating characteristics (ROC) analysis showed that the cutoff value of intrapleural CRP for pleurodesis failure was 25 mg/l on the second postoperative day (sensitivity 87.5 %, specificity 66.6 %, positive predictive value 24.1, negative predictive value 97.7 %). Conclusions: Pleural CRP levels of less than 25 mg/l on the second postoperative day indicate only a moderate pleural inflammation