Measurement of intrapleural pressure in patients with spontaneous pneumothorax: a pilot study

Hiroyuki Kaneda, Takahito Nakano, Tomohiro Murakawa, Hiroyuki Kaneda, Takahito Nakano, Tomohiro Murakawa

Abstract

Background: The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak.

Methods: Patients in whom need aspiration was indicated for spontaneous pneumothorax were enrolled in the study. The intrapleural pressure was measured during stable breathing and data recorded when patients were coughing were excluded.

Results: Eleven patients were enrolled in the study between December 2016 to July 2017. The patterns in change of intrapleural pressure varied widely depending on the state of the pneumothorax. The mean intrapleural pressure values on end-inspiration and end-expiration in patients with persistent air leak was significantly lower than those in patients without persistent air leak (p = 0.020). The number of negative mean pressure recordings in end-inspiration and end-expiration was significantly lower in patients with persistent air leak than in those without persistent air leak (p = 0.0060).

Conclusions: In this study, we demonstrated that intrapleural pressure could be successfully measured and visualized in patients with pneumothorax. Whether or not the pressure value is a predictor of persistent air leak needs to be confirmed in the future.

Keywords: Chest tube drainage; Initial management; Intrapleural pressure; Needle aspiration; Spontaneous pneumothorax.

Conflict of interest statement

The industrial equipment to measure gas pressure was provided by Kobata Gauge Manufacturing Company, Limited (http://www.kobata.co.jp). Hiroyuki Kaneda applied for the system of measurement of intrapleural pressure. Takahito Nakano and Tomohiro Murakawa have nothing to declare.

Figures

Fig. 1
Fig. 1
A periodic curve showing intrapleural pressure during breathing in cases 3 (a), 4 (b), and 5 (c)
Fig. 2
Fig. 2
Changes in intrapleural pressure during evacuation of air in case 1

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