Abstract：
BACKGROUND: Prior studies have found no differences in procedural chest discomfort for patients undergoing manual syringe aspiration or drainage with gravity after thoracentesis. However, whether gravity drainage could protect against chest pain due to the larger negative-pressure gradient generated by wall suction has not been investigated.
OBJECTIVE: Does wall suction drainage result in more chest discomfort compared with gravity drainage in patients undergoing large-volume thoracentesis?
METHODS: In this multicenter, single-blinded, randomized controlled trial, patients with large free-flowing effusions of ≥ 500 mL were assigned at a 1:1 ratio to wall suction or gravity drainage. Wall suction was performed with a suction system attached to the suction tubing and with vacuum pressure adjusted to full vacuum. Gravity drainage was performed with a drainage bag placed 100 cm below the catheter insertion site and connected via straight tubing. Patients rated chest discomfort on a 100-mm visual analog scale before, during, and after drainage. The primary outcome was postprocedural chest discomfort at 5 min. Secondary outcomes included measures of postprocedure chest discomfort, breathlessness, procedure time, volume of fluid drained, and complication rates.
RESULTS: Of the 228 patients initially randomized, 221 were included in the final analysis. The primary outcome of procedural chest discomfort did not differ significantly between the groups (P = .08), nor did the secondary outcomes of postprocedural discomfort and dyspnea. Similar volumes were drained in both groups, but the procedure duration was longer in the gravity arm by approximately 3 min. No differences in rate of pneumothorax or reexpansion pulmonary edema were noted between the two groups.
CONCLUSIONS: Thoracentesis via wall suction and gravity drainage results in similar levels of procedural discomfort and dyspnea improvement.
BACKGROUND: ClinicalTrials.gov; No.: NCT05131945; URL: www.
RESULTS: gov.
OBJECTIVE: Does wall suction drainage result in more chest discomfort compared with gravity drainage in patients undergoing large-volume thoracentesis?
METHODS: In this multicenter, single-blinded, randomized controlled trial, patients with large free-flowing effusions of ≥ 500 mL were assigned at a 1:1 ratio to wall suction or gravity drainage. Wall suction was performed with a suction system attached to the suction tubing and with vacuum pressure adjusted to full vacuum. Gravity drainage was performed with a drainage bag placed 100 cm below the catheter insertion site and connected via straight tubing. Patients rated chest discomfort on a 100-mm visual analog scale before, during, and after drainage. The primary outcome was postprocedural chest discomfort at 5 min. Secondary outcomes included measures of postprocedure chest discomfort, breathlessness, procedure time, volume of fluid drained, and complication rates.
RESULTS: Of the 228 patients initially randomized, 221 were included in the final analysis. The primary outcome of procedural chest discomfort did not differ significantly between the groups (P = .08), nor did the secondary outcomes of postprocedural discomfort and dyspnea. Similar volumes were drained in both groups, but the procedure duration was longer in the gravity arm by approximately 3 min. No differences in rate of pneumothorax or reexpansion pulmonary edema were noted between the two groups.
CONCLUSIONS: Thoracentesis via wall suction and gravity drainage results in similar levels of procedural discomfort and dyspnea improvement.
BACKGROUND: ClinicalTrials.gov; No.: NCT05131945; URL: www.
RESULTS: gov.
摘要：
背景：先前的研究发现，在胸腔穿刺术后接受人工注射器抽吸或重力引流术的患者在手术中胸部不适方面没有差异。然而,重力引流是否可以防止由于壁抽吸产生的较大负压梯度而引起的胸痛尚未研究。
目的：在接受大容量胸腔穿刺术的患者中，与重力引流术相比，壁抽吸引流术是否会导致更多的胸部不适？
方法：在这个多中心，单盲,随机对照试验,大量自由流动积液≥500mL的患者以1∶1的比例被分入壁吸引流术或重力引流术.用连接到抽吸管的抽吸系统和调节到完全真空的真空压力进行壁抽吸。重力引流用引流袋进行,引流袋放置在导管插入部位下方100cm处并通过直管连接。患者在100毫米视觉模拟量表上评估了胸部不适，during,和排水后。主要结果是术后5分钟胸部不适。次要结果包括术后胸部不适的测量，呼吸困难,程序时间,液体排出量和并发症发生率。
结果：在最初随机分配的228例患者中，221个被纳入最终分析。手术胸部不适的主要结局在两组之间没有显着差异（p=0.08），术后不适和呼吸困难的次要结局也没有。两组都排出了相似的体积，但是重力臂的手术持续时间长了大约3分钟。两组之间气胸或再扩张性肺水肿的发生率无差异。
结论：经壁抽吸和重力引流的胸腔穿刺术可导致类似水平的手术不适和呼吸困难改善。
目的：在接受大容量胸腔穿刺术的患者中，与重力引流术相比，壁抽吸引流术是否会导致更多的胸部不适？
方法：在这个多中心，单盲,随机对照试验,大量自由流动积液≥500mL的患者以1∶1的比例被分入壁吸引流术或重力引流术.用连接到抽吸管的抽吸系统和调节到完全真空的真空压力进行壁抽吸。重力引流用引流袋进行,引流袋放置在导管插入部位下方100cm处并通过直管连接。患者在100毫米视觉模拟量表上评估了胸部不适，during,和排水后。主要结果是术后5分钟胸部不适。次要结果包括术后胸部不适的测量，呼吸困难,程序时间,液体排出量和并发症发生率。
结果：在最初随机分配的228例患者中，221个被纳入最终分析。手术胸部不适的主要结局在两组之间没有显着差异（p=0.08），术后不适和呼吸困难的次要结局也没有。两组都排出了相似的体积，但是重力臂的手术持续时间长了大约3分钟。两组之间气胸或再扩张性肺水肿的发生率无差异。
结论：经壁抽吸和重力引流的胸腔穿刺术可导致类似水平的手术不适和呼吸困难改善。
