The Assessment of Heart Function Using Transthoracic Echocardiogram (TTE) Following Thoracentesis on Large-volume Pleural Effusions
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- changes of the TTE diameter after large-volume thoracentesis
研究概览
简要总结
The physiologic basis for relief from dyspnea after therapeutic thoracentesis remains poorly understood. Improvement of the heart and lung function may contribute to the dyspnea relief. But there is no data support this phenomenon. Transthoracic echocardiogram (TTE) is a non-invasive viewing of the heart, which can quickly assess the heart function through real-time images. The investigators performed thoracentesis on patients with large-volume pleural effusions, and utilized TTE to access the change of heart and lung function before and after this medical procedure.
详细描述
Patients with large pleural effusions often experience dramatic and immediate relief from dyspnea after therapeutic thoracentesis. Although this is a well-recognized phenomenon, the physiologic basis for such relief remains poorly understood. Primary physiologic basis for the relief in dyspnea after thoracentesis may include the improvement of the heart and lung function. In some cases the improvement in breathlessness cannot be attributed to the improvement of gas exchange, due to the atelectatic lung(not fully expansion of the lung). Transthoracic echocardiogram (TTE) is a non-invasive, real-time viewing of the internal parts of the heart using ultrasound, which can get highly accurate and quick assessment of the various heart images, though which doctors can quickly assess a patient's heart valves and degree of heart muscle contraction.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 14 Years 至 75 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •the estimated amount of effusion is above 500 ml;
- •Drainage was not performed within 1 month before admission;
- •assigned informed consent.
排除标准
- •physical weakness which is difficult to withstand the thoracentesis;
- •the happening of serious pleural reaction or reexpansion pulmonary edema on previous thoracentesis;
- •allergy to the anesthetic;
- •coagulation dysfunction, severe bleeding tendency;
- •serious mental illness who do not cooperate;
- •suspected with pleural hydatid disease;
- •skin infection around supine positioning;
- •severe heart function insufficiency who cannot lay on the back;
- •for a variety of reasons that cannot accept regular follow-up;
- •refused to sign the informed consent;
- •other conditions that is not suitable for the test.
结局指标
主要结局
changes of the TTE diameter after large-volume thoracentesis
时间窗: baseline, immediately after drainage, 24 h after the thoracentesis
change of the UCG diameter of the patients, including : Left ventricular: Left ventricular end-diastolic diameter(LVEDD）, Left ventricular end-systolic diameter（LVESD）, Left ventricular end-diastolic volume （LVEDV ）, Left ventricular end-systolic volume（ LVESV）, Left ventricular ejection fraction（LVEF）,Stroke volume（SV）,Cardiac output（CO），left ventricular diastolic function, including：E、A、E/A、E/Em、Em、Am（By PW\&DTI）；Global longitudinal strain(GLS）; right ventricular：Basal and mid-cavity transversal right ventricular diameter, right ventricular free wall thickness, Tricuspid annular plane systolic excursion（TAPSE）, Fractional area change（FAC）, right ventricular systolic strain, Left and right atrial volume, coronary artery diameter
次要结局
- changes of the distances on 6-MWT after large-volume thoracentesis(baseline, immediately after drainage, 24 h after the thoracentesis)
研究者
Shi Huanzhong
Director of Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital
Beijing Chao Yang Hospital