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1.
Anesthesia and Pain Medicine ; : 206-212, 2022.
Article in English | WPRIM | ID: wpr-937116

ABSTRACT

The number of patients with end-stage renal disease (ESRD) who are dependent on hemodialysis is increasing rapidly. As a result, more patients with ESRD need surgery. These patients have a significantly higher risk of postoperative death than those with normal kidney function. Therefore, this study analyzed the causes of postoperative mortality in ESRD patients undergoing surgery under general anesthesia and the risk factors for postoperative mortality. Methods: This retrospective analysis examined the mortality of ESRD patients, 20 to 80 years old, undergoing surgery under general anesthesia. We excluded patients who underwent cardiac, cancer, or emergency surgery or organ transplantation from the analysis. The primary outcome was the cause of postoperative 30-day mortality in ESRD patients. We also assessed the mortality rate and risk factors. Results: There were 2,459 eligible ESRD patients. When patients underwent multiple surgeries during the study period, only the last surgery was considered. In total, 167 patients died during the study period, including 65 within 30 days postoperatively. The cause of death was sepsis in 22 cases (33.8%) and a major cardiac event in 16 (24.6%). Atrial fibrillation, current angina, previous myocardial infarction, asthma, lower hemoglobin and albumin levels, and a larger intraoperative colloid volume were likely to increase mortality. Conclusions: Our study suggests that immunological issues have a significant role in the death of ESRD patients after general anesthesia.

2.
Korean Journal of Anesthesiology ; : 37-46, 2022.
Article in English | WPRIM | ID: wpr-926566

ABSTRACT

Background@#We compared upper- and lower-body forced-air blankets in terms of their ability to prevent perioperative hypothermia, defined as a reduction in body temperature to < 36.0°C, during the perioperative period in patients undergoing spine surgery in the prone position. @*Methods@#In total, 120 patients scheduled for elective spine surgery under general anesthesia were divided into an upper-warming group (n = 60) and a lower-warming group (n = 60). After inducing anesthesia and preparing the patient for surgery, including prone positioning, the upper and lower bodies of the patients in the upper- and lower-warming groups, respectively, were warmed using a forced-air warmer with specified upper and lower blankets. Body temperature was measured using a tympanic membrane thermometer during the pre- and post-operative periods and using a nasopharyngeal temperature probe during the intraoperative period. Patients were evaluated in terms of shivering, thermal comfort, and satisfaction in the post-anesthesia care unit (PACU). @*Results@#The incidence of intraoperative and postoperative hypothermia was lower in the upper-warming group than in the lower-warming group ([55.2% vs. 75.9%, P = 0.019] and [21.4% vs. 49.1%, P = 0.002]). Perioperative body temperature was higher in the upper-warming group (P < 0.001). However, intraoperative blood loss, postoperative thermal comfort scale and shivering scores, patient satisfaction, and PACU duration were similar in the two groups. @*Conclusions@#The upper-body blanket was more effective than the lower-body blanket for preventing perioperative hypothermia in patients who underwent spine surgery in the prone position.

3.
Anesthesia and Pain Medicine ; : 356-364, 2020.
Article | WPRIM | ID: wpr-830315

ABSTRACT

Background@#This study aimed to evaluate the efficacy of 10-min pre-warming in preventing inadvertent perioperative hypothermia, which is defined as a reduction in body temperature to less than 36.0℃ during the perioperative period in intraoperative warming patients. @*Methods@#In this prospective randomized study, 60 patients scheduled for elective surgery under general anesthesia lasting less than 120 min were divided into two groups: the 10-min pre-warming group (n = 30) and the control group (n = 30). Patients in the 10-min pre-warming group were pre-warmed for 10 min in the pre-anesthetic area using a forced-air warmer set at 47ºC. Intraoperatively, we warmed all patients with a forced-air warmer. Body temperature was measured using a tympanic membrane thermometer pre- or postoperatively and a nasopharyngeal temperature probe intraoperatively. Patients were evaluated on the shivering and thermal comfort scale in the pre-anesthetic area and post-anesthesia care unit. @*Results@#The incidences of intraoperative hypothermia and postoperative hypothermia were similar in both groups (10.7% vs. 28.6%, P = 0.177; 10.7% vs. 10.7%, P = 1.000 respectively). Body temperature was higher in the 10-min pre-warming group (P = 0.003). Thermal comfort during the pre-warming period was higher in the 10-min pre-warming group (P < 0.001). However, postoperative thermal comfort and shivering grades of both groups were similar. @*Conclusions@#Ten minutes of pre-warming has no additional effect on the prevention of inadvertent perioperative hypothermia in intraoperative warming patients.

4.
Soonchunhyang Medical Science ; : 160-163, 2018.
Article in English | WPRIM | ID: wpr-718707

ABSTRACT

OBJECTIVE: Although the reference value of cardiac index (CI) is derived by pulmonary arterial pressure, the use of pulmonary arterial catheterization is limited by low cost effectiveness and many concerns regarding complications. Therefore, relatively noninvasive indirect measurement is used widely perioperatively. The goal of this study was to determine the accuracy of the CI derived by Mobil-O-Graph NG (cCI) noninvasively in patients undergoing general anesthesia by comparing that measured by FloTrac/Vigileo (fCI), the minimal invasive method. METHODS: The Bland-Altman method was used to quantify agreement. Bias (mean difference between fCI-cCI) represents the systematic error between methods and precision (standard deviation of the bias) represents the random error or variability between techniques. The percentage error was considered clinically acceptable, and the tested method (Mobil-O-Graph NG) was regarded as interchangeable with the reference method (FloTrac/Vigileo), if it was below 30%. RESULTS: One hundred and ninety-five patients were included in this study, and CI, measured in the 121 patients. The Bland-Altman analysis revealed a bias −0.01 and the percentage error of 32.4%. And the difference is inversely increased according the mean CI. CONCLUSION: Results showed that CI measured by Mobil-O-Graph NG had a wide limit of agreement with that measured by FloTrac/Vigileo, therefore regarded as not interchangeable.


Subject(s)
Humans , Anesthesia, General , Arterial Pressure , Bias , Cardiac Output , Catheterization , Catheters , Cost-Benefit Analysis , Methods , Monitoring, Physiologic , Reference Values
5.
Soonchunhyang Medical Science ; : 101-104, 2018.
Article in Korean | WPRIM | ID: wpr-714892

ABSTRACT

A 72-year-old man with chronic renal failure underwent cephalic vein bypass surgery. He also had diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. To avoid the exacerbation of chronic obstructive pulmonary disease, the surgery began under epidural anesthesia with no sedation and oxygen supply via simple mask. During the surgery, desaturation occurred abruptly to 83%. Desaturation continued after intubation for a while and slowly disappeared as time went by. After the surgery, in the intensive care unit we performed a bronchoscopic examination and found large amount of sputum in both bronchioles. After bronchial suction and toileting, extubation was performed. In the patient with chronic obstructive pulmonary disease, it is possible that desaturation occurs abruptly due to acute exacerbation, although the surgery is conducted under epidural anesthesia with no sedation.


Subject(s)
Aged , Humans , Anesthesia, Epidural , Bronchioles , Diabetes Mellitus , Hypertension , Intensive Care Units , Intubation , Kidney Failure, Chronic , Masks , Oxygen , Pulmonary Disease, Chronic Obstructive , Sputum , Suction , Veins
6.
Anesthesia and Pain Medicine ; : 447-453, 2018.
Article in Korean | WPRIM | ID: wpr-717871

ABSTRACT

BACKGROUND: At least 30 minutes of pre-warming has been recommended for the prevention of redistribution hypothermia. However, it has been reported that less than 30 minutes of pre-warming is also effective. The aim of this study was to evaluate the ability of 10 minutes of pre-warming to prevent inadvertent perioperative hypothermia. Results were compared with 30 minutes of pre-warming. METHODS: In this prospective randomized study, 59 patients scheduled for elective surgery less than 120 minutes under general anesthesia were divided into 2 groups: the first group was pre-warmed for 10 minutes (n = 30), the second group for 30 minutes (n = 29). The patients were pre-warmed for 10 or 30 minutes in the pre-anesthetic area using a forced-air warmer. When the patients' body temperatures decreased below 36℃, we warmed them with a forced-air warmer intraoperatively and postoperatively. Body temperatures were recorded during perioperative periods. Shivering and thermal comfort were evaluated in the pre-anesthetic area and post-anesthesia care unit. RESULTS: The incidence of intraoperative and postoperative hypothermia were not significantly different (P > 0.05). However, the temperatures were higher in the 30 minute group from the post-warming time to 90 minutes after anesthetic induction (P < 0.05). CONCLUSIONS: Ten minutes of pre-warming has the same effectiveness as 30 minutes of pre-warming for preventing inadvertent perioperative hypothermia. It is a preferable choice for the patients scheduled for surgery less than 120 minutes under general anesthesia.


Subject(s)
Humans , Anesthesia, General , Body Temperature , Hypothermia , Incidence , Perioperative Period , Prospective Studies , Shivering
7.
Anesthesia and Pain Medicine ; : 68-71, 2017.
Article in Korean | WPRIM | ID: wpr-21260

ABSTRACT

BACKGROUND: Previous studies have shown that measuring the distance from the skin to the ligamentum flavum by ultrasound preceding cervical epidural block can be beneficial in excluding false loss of resistance. However, the measurement value using ultrasound may vary depending on the degree of operator experience. Therefore, we aimed to determine the depth from skin to cervical epidural space by using lateral cervical spine X-ray, which is a more intuitive method. METHODS: We enrolled 102 adult patients who were scheduled to undergo cervical epidural anesthesia for vascular bypass surgery of upper arm. After attaching a steel rod on the needle insertion site, lateral cervical spine X-ray was taken before the epidural procedure. We measured the distance from the steel rod to the midpoint of interlaminar space on the spinolaminar line. The X-ray depth was compared with needle depth. RESULTS: Of the 102 enrolled patients, 18 patients including 13 in whom we were unable to measure X-ray depth were excluded from the analysis. In total, 84 patients were included in the analysis. Concordance correlation coefficient between the X-ray-measured depth and needle depth was 0.925. Bland-Altman analysis indicated a mean difference of ± 1.96 SD with 0.06 ± 0.56 cm. CONCLUSIONS: Lateral cervical spine X-ray can be useful for prediction of the midline depth from skin to epidural space, particularly for operators who are not skilled at spine ultrasound or the use the C-arm fluoroscopy.


Subject(s)
Adult , Female , Humans , Anesthesia , Anesthesia, Epidural , Arm , Cervical Vertebrae , Epidural Space , Fluoroscopy , Ligamentum Flavum , Methods , Neck , Needles , Skin , Spine , Steel , Ultrasonography
8.
Soonchunhyang Medical Science ; : 146-148, 2017.
Article in Korean | WPRIM | ID: wpr-17188

ABSTRACT

A 43-year-old woman with left facial pain caused by occipital neuralgia was scheduled for C2 ganglionotomy and adhesiolysis of left C2 root. General anesthesia, surgical procedure, and emergence have done uneventfully. However, she developed seizure after 5 minutes postoperatively in post-anesthesia recovery unit. She showed loss of consciousness and generalized muscular rigidity after shouting “I want to die”. Neurologic examination and neuroimaging revealed no neuronal damage. Her generalized muscular rigidity improved by her daughter's visit and worsened by mention about her husband, and disappeared after 40 minutes spontaneously.


Subject(s)
Adult , Female , Humans , Anesthesia, General , Facial Pain , Muscle Rigidity , Neuralgia , Neuroimaging , Neurologic Examination , Neurons , Seizures , Spouses , Unconsciousness
9.
Soonchunhyang Medical Science ; : 152-154, 2017.
Article in Korean | WPRIM | ID: wpr-17186

ABSTRACT

Central venous catheterization is a useful procedure for administrating fluids and drugs as well as monitoring central venous pressure in the operating room. The internal jugular vein and the subclavian vein are preferred as catheter insertion sites because of the low risk of infection and mechanical complications. However, the risk of venous malposition is higher in subclavian vein. The loop formation of the central venous catheter accompanied by its malposition increases the risk of thrombosis. If the procedure is to be performed with any difficulty, early radiologic examination should be required to detect and avoid complications. We report a case of malposition and loop formation of central venous catheter located in subclavian vein confirmed by chest X-ray after transferred to the intensive care unit.


Subject(s)
Catheterization, Central Venous , Catheters , Central Venous Catheters , Central Venous Pressure , Intensive Care Units , Jugular Veins , Operating Rooms , Subclavian Vein , Thorax , Thrombosis
10.
Journal of Korean Academy of Community Health Nursing ; : 196-205, 2017.
Article in Korean | WPRIM | ID: wpr-114924

ABSTRACT

PURPOSE: Art program has been found to enhance mood such as increasing motivation, self-expression and decreasing depression in older adults. This study was conducted to investigate the effects of clay art and drawing on depression and self-expression among elderly people at a long-term care center. METHODS: The research was a pre-test and post-test non-equivalent design. Sixty older patients (clay art program=28. Drawing art program=32) over the age of 65 were recruited from 2 long-term care hospitals to participate in the 5 weeks program. Each group was scheduled with 10,120-minute evaluation sessions, twice per week. Test measures were completed before and after the 5 week intervention period for all participants. The data was collected from April 27 to May 29, 2015. It was analyzed with SPSS 22.0 using chi-square, t-test and paired t-test. RESULTS: There were no significant difference in the levels of depression (t=0.21, p=.830) and total score of self-expression (t=-0.10, p=.919) between the two groups. However, the pre-post scores of self-expression in the clay art program (t=0.22, p=.826) were improved compared to the drawing art program (t=0.80, p=.430). CONCLUSION: Further studies are needed to evaluate the effectiveness of clay art program for extended senior care applications.


Subject(s)
Adult , Aged , Humans , Art Therapy , Depression , Long-Term Care , Motivation
11.
Soonchunhyang Medical Science ; : 92-97, 2016.
Article in Korean | WPRIM | ID: wpr-84369

ABSTRACT

OBJECTIVE: Many studies have demonstrated that carbon dioxide has direct depressive effects on the myocardium and dilates the vascular bed. However, it leads to an increase in arterial blood pressure and cardiac output because of sympathetic stimulating effect. Extensive epidural block may impair the sympathetic innervation to the heart as well as to the adrenal gland. The present study was set up in order to investigate how an extensive epidural block would affect the hemodynamic response to sympathetic stimulation induced by hypercapnia. METHODS: Twenty patients were mechanically ventilated under general anesthesia after epidural catheter insertion on T6–T7 intervertebral space. Hypercapnia was obtained by CO2 breathing. PaCO2 (partial pressure of CO2, arterial) was adjusted to 30, 45, and 60 mm Hg with each concentration being maintained for 10 minutes. In each period, hemodynamic variables were monitored by pulmonary artery catheter. After returning to normocarbia for 15 minutes, 20 mL of 0.375% ropivacaine was injected epidurally and PaCO2 was adjusted in the same manner, and then, the hemodynamic variables of each period were checked. RESULTS: There were no changes in mean arterial pressure and heart rate by hypercapnia after combined epidural anesthesia compared with general anesthesia only. Hypercapnia increased cardiac output and cardiac index. Systemic vascular resistance was decreased significantly. Pulmonary artery pressure was increased but not significantly. The degrees of hemodynamic changes were similar between in general anesthesia alone and in combined epidural anesthesia. CONCLUSION: In spite of an extensive epidural block, hemodynamic changes induced by hypercarbnia were not changed. There are some ‘escaped’ sympathetic nerve fibers.


Subject(s)
Humans , Adrenal Glands , Anesthesia , Anesthesia, Epidural , Anesthesia, General , Arterial Pressure , Carbon Dioxide , Cardiac Output , Catheters , Heart , Heart Rate , Hemodynamics , Hypercapnia , Myocardium , Nerve Fibers , Pulmonary Artery , Respiration , Vascular Resistance
12.
Journal of the Korean Neurological Association ; : 328-330, 2015.
Article in Korean | WPRIM | ID: wpr-206094

ABSTRACT

Ocular flutter is a relatively rare eye movement disorder that refers to occasional bursts of involuntary horizontal oscillation around the point of fixation, characterized by rapid, repetitive, horizontal, symmetrical and sinusoidal oscillation without inter- saccadic interval. It is known to be associated with disorders of the cerebellum and brainstem resulting from various pathological conditions, but it's anatomical and pathophysiological basis remains unclear. Here, we present the case of a patient who had severe ocular flutter associated with Merkel cell carcinoma.


Subject(s)
Humans , Brain Stem , Carcinoma, Merkel Cell , Cerebellum , Ocular Motility Disorders , Paraneoplastic Syndromes
13.
Soonchunhyang Medical Science ; : 64-66, 2014.
Article in Korean | WPRIM | ID: wpr-69008

ABSTRACT

Spontaneous intracranial hypotension is a syndrome caused by cerebrospinal fluid (CSF) leakage from the spinal dural sac. The most common symptom is a postural headache and other clinical symptoms may include nausea, vomiting, photophobia, diplopia, dizziness, and tinnitus. Usually, conservative treatments like hydration, bed rest, and administration of caffeine are recommended first, but epidural blood patch is regarded as the mainstay of treatment in the patients who do not respond to conservative therapy. Epidural blood patch was known that it provides the tamponade and seal of dural sac when performed at the leak site. Our patient was suspected the CSF leakage at cervicothoracic junction, but epidural blood patch was performed in lumbar level and the headache of patient was managed successfully for at least 1 year.


Subject(s)
Humans , Bed Rest , Blood Patch, Epidural , Caffeine , Cerebrospinal Fluid , Diplopia , Dizziness , Headache , Intracranial Hypotension , Nausea , Photophobia , Tinnitus , Vomiting
14.
Yonsei Medical Journal ; : 379-386, 2014.
Article in English | WPRIM | ID: wpr-19551

ABSTRACT

PURPOSE: To evaluate the risk factors of hepatocellular carcinoma (HCC) extension into the right atrium (RA) and determine poor prognostic factors for HCC extension to the heart. MATERIALS AND METHODS: A total of 665 patients who were newly diagnosed with HCC were analyzed retrospectively from January 2004 to July 2012. The patients were divided into two groups: 33 patients with HCC extending into the RA and 632 HCC patients during the same period. The patients with HCC extending into the RA were subdivided into shorter survival group ( or =2 months). RESULTS: The prevalence of HCC extending to the RA was 4.96%. In multivariate analysis, a modified Union Internationale Contre le Cancer (UICC) stage higher than IVA, hepatic vein invasion, concomitant inferior vena cava and portal vein invasion, and multinodular tumor type were risk factors for HCC extending to the RA. In multivariate analysis, Cancer of the Liver Italian Program (CLIP) score >3 (p=0.016, OR: 13.89) and active treatment (p=0.024, OR: 0.054) were associated with prognostic factors in patients HCC extending into the RA. Active treatment such as radiation (n=1), transcatheter arterial chemoembolization (TACE) (n=11), Sorafenib (n=1), and combined modalities (n=2) were performed. CONCLUSION: Modified UICC stage higher than IVA, vascular invasion and multinodular tumor type are independent risk factors for HCC extending to the RA. Active treatment may prolong survival in patients HCC extending into the RA.


Subject(s)
Humans , Carcinoma, Hepatocellular , Heart Atria , Heart , Hepatic Veins , Liver Neoplasms , Methods , Multivariate Analysis , Neoplasm Metastasis , Portal Vein , Prevalence , Prognosis , Retrospective Studies , Risk Factors , Vena Cava, Inferior
15.
Korean Journal of Anesthesiology ; : S51-S52, 2014.
Article in English | WPRIM | ID: wpr-144903

ABSTRACT

No abstract available.


Subject(s)
Catheters , Epidural Space
16.
Korean Journal of Anesthesiology ; : S51-S52, 2014.
Article in English | WPRIM | ID: wpr-144890

ABSTRACT

No abstract available.


Subject(s)
Catheters , Epidural Space
17.
Korean Journal of Anesthesiology ; : 198-204, 2014.
Article in English | WPRIM | ID: wpr-175784

ABSTRACT

BACKGROUND: Neck and shoulder pain is fairly common among adolescents in Korea and results in significant health problem. The aims of this prospective study was to identify the effects of education, in terms of recognition of this issue and posture correction, on prevalence and severity of neck and shoulder pain in Korean adolescents. METHODS: A prospective, observational cohort design was used. The 912 students from two academic high schools in the city of Seoul were eligible for the current study and 887 completed this study. After a baseline cross-sectional survey, students listened to a lecture about cervical health, focusing on good posture, habits, and stretching exercises to protect the spine, and were encouraged by their teachers to keep the appropriate position. And follow-ups were conducted 3 months later, to evaluate the effect of education. RESULTS: The prevalence of neck and shoulder pain was decreased 19.5% (from 82.5 to 66.4%). The baseline mean usual and worst numeric rating scale were 19.9/100 (95% CI, 18.1-21.7) and 31.2/100 (95% CI, 28.7-33.2), respectively. On the follow-up survey, the mean usual and worst numeric rating scale were decreased significantly by 24.1 and 21.7%, respectively, compared with baseline (P < 0.01). Of the 570 students reporting neck and shoulder pain, 16.4% responded that they had experienced improvement during the 3 months. CONCLUSIONS: Education; recognition of this issue and posture correction, for cervical health appeared to be effective in decreasing the prevalence and severity of neck and shoulder pain at a 3 month follow-up.


Subject(s)
Adolescent , Humans , Cohort Studies , Cross-Sectional Studies , Education , Exercise , Follow-Up Studies , Korea , Longitudinal Studies , Neck Pain , Neck , Posture , Prevalence , Prospective Studies , Seoul , Shoulder Pain , Spine
18.
Korean Journal of Anesthesiology ; : 398-403, 2014.
Article in English | WPRIM | ID: wpr-114082

ABSTRACT

BACKGROUND: Transverse abdominis plane (TAP) block can be recommended as a multimodal method to reduce postoperative pain in laparoscopic abdominal surgery. However, it is unclear whether TAP block following local anesthetic infiltration is effective. We planned this study to evaluate the effectiveness of the latter technique in laparoscopic totally extraperitoneal hernia repair (TEP). METHODS: We randomly divided patients into two groups: the control group (n = 37) and TAP group (n = 37). Following the induction of general anesthesia, as a preemptive method, all of the patients were subjected to local anesthetic infiltration at the trocar sites, and the TAP group was subjected to ultrasound-guided bilateral TAP block with 30 ml of 0.375% ropivacaine in addition before TEP. Pain was assessed in the recovery room and post-surgery at 4, 8, and 24 h. Additionally, during the postoperative 24 h, the total injected dose of analgesics and incidence of nausea were recorded. RESULTS:: On arrival in the recovery room, the pain score of the TAP group (4.33 +/- 1.83) was found to be significantly lower than that of the control group (5.73 +/- 2.04). However, the pain score was not significantly different between the TAP group and control group at 4, 8, and 24 h post-surgery. The total amounts of analgesics used in the TAP group were significantly less than in the control group. No significant difference was found in the incidence of nausea between the two groups. CONCLUSIONS: TAP block following local infiltration had a clinical advantage only in the recovery room.


Subject(s)
Humans , Analgesics , Anesthesia, General , Hernia , Herniorrhaphy , Incidence , Nausea , Pain, Postoperative , Recovery Room , Surgical Instruments , Ultrasonography
19.
Soonchunhyang Medical Science ; : 29-30, 2013.
Article in English | WPRIM | ID: wpr-8457

ABSTRACT

Awareness of intraoperative events in patients under general anesthesia is rare, but awareness during anesthesia is a serious complication that leads to anxiety and post-traumatic stress disorder. The Bispectral Index (BIS) has generally been accepted as a measurement of hypnosis under anesthesia. It is derived from a processed electroencephalogram and computer algorithm that assigns a numerical value based on the probability of consciousness. A 46-year-old, 65-kg male without underlying disease underwent elective surgery for ventral hernia. The patient in this case was administered an anesthetic that we frequently use and then average BIS value are 35. But he experienced awake during general anesthesia. We describe the first case of intraoperation awake under BIS 40 using desflurane.


Subject(s)
Humans , Male , Anesthesia , Anesthesia, General , Anxiety , Consciousness , Consciousness Monitors , Electroencephalography , Hernia, Ventral , Hypnosis , Intraoperative Awareness , Intraoperative Complications , Isoflurane , Mental Recall , Stress Disorders, Post-Traumatic
20.
Tuberculosis and Respiratory Diseases ; : 244-249, 2013.
Article in English | WPRIM | ID: wpr-194720

ABSTRACT

BACKGROUND: Conventional biomarkers cannot always establish the cause of pleural effusions; thus, alternative tests permitting rapid and accurate diagnosis are required. The primary aim of this study is to assess the ability of pentraxin-3 (PTX3) in order to diagnose the cause of pleural effusion and compare its efficacy to that of other previously identified biomarkers. METHODS: We studied 118 patients with pleural effusion, classified as transudates and exudates including malignant, tuberculous, and parapneumonic effusions (MPE, TPE, and PPE). The levels of PTX3, C-reactive protein (CRP), procalcitonin (PCT) and lactate in the pleural fluid were assessed. RESULTS: The levels of pleural fluid PTX3 were significantly higher in patients with PPE than in those with MPE or TPE. PTX3 yielded the most favorable discriminating ability to predict PPE from MPE or TPE by providing the following: area under the curve, 0.74 (95% confidence interval, 0.63-0.84), sensitivity, 62.07%; and specificity, 81.08% with a cut-off point of 25.00 ng/mL. CONCLUSION: Our data suggests that PTX3 may allow improved differentiation of PPE from MPE or TPE compared to the previously identified biomarkers CRP and PCT.


Subject(s)
Humans , Biomarkers , C-Reactive Protein , Diagnosis , Diagnosis, Differential , Exudates and Transudates , Lactic Acid , Pleural Effusion
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