Diagnosis of parapneumonic pleural effusion with serum and pleural fluid Activin A.

OBJECTIVE: The aim is to evaluate the diagnostic value of Activin A levels in serum and pleural fluid on Parapneumonic Pleural Effusion (PPE). METHODS: The authors collected serum and pleural fluid from 86 PPE and 37 Non-PPE (NPPE) patients. Including Activin A, levels of biomarkers such as Lactate Dehydrogenase (LDH), Procalcitonin (PCT), and C-Reactive Protein (CRP) were measured. All factors were calculated for association with days after admission. The diagnostic potential of biomarkers on PPE was considered by Receiver Operating Characteristic (ROC) curve analysis. RESULTS: Levels of Activin A in serum and pleural fluid of PPE patients were significantly higher than those of the NPPE patients. Moreover, concentrations of Activin A in pleural fluid showed a more obvious relevant days after admission. ROC curve analysis found that Activin A in pleural fluid had AUCs of 0.899 with 93% sensitivity and 84% specificity for PPE diagnosis. CONCLUSION: Activin A in pleural fluid correlated with disease severity could act to diagnose PPE.

Diagnosis of parapneumonic pleural effusion with serum and pleural fluid Activin A

Abstract Objective The aim is to evaluate the diagnostic value of Activin A levels in serum and pleural fluid on Parapneumonic Pleural Effusion (PPE). Methods The authors collected serum and pleural fluid from 86 PPE and 37 Non-PPE (NPPE) patients. Including Activin A, levels of biomarkers such as Lactate Dehydrogenase (LDH), Procalcitonin (PCT), and C-Reactive Protein (CRP) were measured. All factors were calculated for association with days after admission. The diagnostic potential of biomarkers on PPE was considered by Receiver Operating Characteristic (ROC) curve analysis. Results Levels of Activin A in serum and pleural fluid of PPE patients were significantly higher than those of the NPPE patients. Moreover, concentrations of Activin A in pleural fluid showed a more obvious relevant days after admission. ROC curve analysis found that Activin A in pleural fluid had AUCs of 0.899 with 93% sensitivity and 84% specificity for PPE diagnosis. Conclusion Activin A in pleural fluid correlated with disease severity could act to diagnose PPE.

Hallazgos citoquímicos en líquido pleural de pacientes con COVID-19, atendidos en un servicio de emergencia / Cytochemical findings in pleural fluid from patients with COVID-19, cared for in an emergency department

Objetivo: El presente trabajo tuvo como propósito describir las características físicas, citológicas y bioquímicas, así como clasificar los líquidos pleurales de pacientes con COVID-19 como exudados o trasudados. Material y Métodos: Se realizó un estudio observacional, transversal descriptivo. Se recopiló datos del examen citoquímico de muestras de líquido pleural procesadas entre los meses de abril a setiembre del 2020, en el laboratorio del Centro de Emergencias de Lima Metropolitana (CELIM). Resultados: Durante el periodo de estudio un total de 81 muestras de líquido pleural de pacientes con COVID-19 fueron evaluadas, de estos, 26 cumplieron con nuestros criterios de elegibilidad. Catorce líquidos (54%), tuvieron un color rojo y 18 (69%) tuvieron un aspecto turbio. Los líquidos pleurales exudativos fueron la mayoría (n = 17), las proteínas totales presentaron una media de 3.3 gr/dl (DE: 1.5), LDH una mediana de 544 U/L (RIC: 262-2016), el recuento leucocitario tuvo una mediana de 610 leucocitos/ul (RIC: 180-968) y el recuento diferencial de polimorfonucleares una mediana 29% (RIC: 15-60). En cuanto a las características clínicas, del total de exudados el 41% correspondían a neoplasias y el 23% a neumonías. Mientras que, del total de trasudados (n=9), 45% provenían de pacientes con neoplasias. Conclusiones: En nuestro estudio observamos que la mayoría de las muestras de líquido pleural de pacientes con COVID-19 fueron clasificadas como exudados. Estas presentaron un bajo porcentaje diferencial leucocitario de polimorfonucleares. Los valores de los parámetros bioquímicos tales como proteínas totales y LDH se relacionaron adecuadamente con la clasificación de exudados.

Objetive:The purpose of this work was to describe the physical, cytological and biochemical characteristics, as well as to classify the pleural fluids of patients with COVID-19 as exudates or transudates. Materials and Methods: An observational, descriptive cross-sectional study was carried out. Data was collected from the cytochemical examination of pleural fluid samples processed between the months of April to September 2020, in the laboratory of the Emergency Center of Metropolitan Lima (CELIM). Results: During the study period, a total of 81 samples of pleural fluid from patients with COVID-19 were evaluated, of these, 26 met our eligibility criteria. Fourteen liquids (54%) had a red color and 18 (69%) had a cloudy appearance. Exudative pleural fluids were the majority (n = 17), total proteins presented a mean of 3.3 g / dl (SD: 1.5), LDH a median of 544 U / L(IQR: 262-2016), the leukocyte count had a median of 610 leukocytes / ul (IQR: 180-968) and the differential polymorphonuclear count a median 29% (IQR: 15-60). Regarding the clinical characteristics, of the total exudates, 41% corresponded to neoplasms and 23% to pneumonia. While, of the total transudates (n = 9), 45% came from patients with neoplasms. Conclusions: In our study we observed that most of the pleural fluid samples from patients with COVID-19 were classified as exudates. These presented a low differential leukocyte percentage of polymorphonuclear cells. The values of the biochemical parameters such as total proteins and LDH were adequately related to the classification of exudates.

Extension of the thoracic spine sign as a diagnostic marker for thoracic trauma.

INTRODUCTION: The initial evaluation of patients with thoracic trauma remains a diagnostic challenge for surgery and emergency physicians. Chest sonography plays a key role in the approach for this group of patients, through extended and focused evaluation with trauma sonography (E-FAST). OBJECTIVES: To establish the diagnostic performance of the extension of the thoracic spine sign using chest sonography in trauma to diagnose hemothorax and compare it with the gold standard test chest computed tomography (CT). METHODS: This prospective observational study was conducted over 1 year. Patients who attended the emergency room with closed or penetrating thoracic or thoraco-abdominal trauma, an indication for a chest CT as part of a diagnostic evaluation according to institutional protocols, and who previously underwent a chest sonogram to determine the extent of the thoracic spine sign to diagnose hemothorax. Sonographic results were compared to a radiologist's interpretation of the chest CT. The radiologists were blinded to the initial sonogram interpretation. RESULTS: Seventy-six patients were enrolled with an average age of 32 years. They mainly had closed trauma, which accounted for 77.6% of samples, and 222 chest images were taken. The sensitivity and specificity for this study were 78.7% and 92.6%, respectively, with a positive predictive value and negative predictive value of 65% and 97.8%, respectively. CONCLUSIONS: Extension of the thoracic spine sign allows rapid identification of the presence, and more precisely, the absence of pleural effusion. This, therefore, allows an appropriate diagnosis and approach in the emergency room in patients with chest trauma.

Identifying pneumococci in parapneumonic pleural effusion: Is there a role for culture-independent methods?

OBJECTIVE: To evaluate culture-independent procedures (immunochromatography and quantitative polymerase chain reaction [qPCR]) in the detection and susceptibility of Streptococcus pneumoniae directly from culture-negative pleural fluid (PF) in children. METHOD: Detection of S. pneumoniae in PF of children with parapneumonic effusion and/or empyema by using two culture-independent methods: an immunochromatographic membrane test (IMT) which identifies the pneumococcal C antigen, and a real-time PCR test to detect pneumococcal genes lytA and pbp2b, a marker of susceptibility of ß-lactam agents, in PF samples. RESULTS: We tested 36 PF specimens and recorded the previous use of antimicrobials. In the final analysis, 34 samples were included. IMT and qPCR presented positive results in 23 (67.6%) and 24 (70.6%) of the samples, respectively, showing a moderate agreement (k = 0.518) between the two methods. From the 36 children included, 34 (94.4%) had antibiotic data available by the time when PFs were collected. Thirty-four (100%) children had been given treatment before PF sampling, with 33 (97%) receiving ß-lactam antibiotics administered empirically. Of the 24 lytA real-time positive samples, 21 (87.5%) were also positive for pbp2b, a marker of ß-lactam susceptibility. CONCLUSION: The reduced sensitivity of culture for pneumococcal detection can be improved through the addition of IMT and qPCR analysis. The utility of qPCR combining detection of lytA and a marker of ß-lactam susceptibility should be explored further.

Tuberculous pleural effusion: diagnosis & management.

Background: Tuberculosis (TB) is the world's leading cause of death from infectious disease. The World Health Organization (WHO) recognized 6.3 million new TB cases in 2017, 16% corresponding to extrapulmonary forms; pleural tuberculosis (PT) is the most common extrapulmonary form in adults. PT diagnosis is often challenging because the scarcity of bacilli in pleural fluid (PF), sometimes requiring invasive procedures to obtain pleural tissue for histological, microbiological or molecular examination. In regions of medium and high disease prevalence, adenosine deaminase (ADA), interferon gamma (IFN-γ) and interleukin 27 (IL-27) dosages are useful to establish presumptive diagnosis in patients with compatible clinical/radiological picture who present with lymphocytic pleural effusion. PT treatment is similar to the pulmonary TB treatment regimen recommended by WHO. Area covered: In this update, we present a PT review, including epidemiology, pathogenesis, clinical features, diagnosis, and therapy. Expert opinion: There is no PF test alone accurate for PT diagnosis, despite the evolution in clinical laboratory. ADA, IFN-γ and IL-27 are valuable laboratory biomarkers; however, IFN-γ and IL-27 are quite expensive. Molecular tests present low sensitivity in PF, being useful for diagnostic confirmation. Multidrug therapy remains the PT treatment choice. Advancing research in immunotherapy may bring benefits to PT patients.

Preanalytical conditions can interfere with M. tuberculosis detection by PCR in respiratory samples

OBJECTIVES: Tuberculosis is one of the most prevalent infections in humans. Although culture is the reference for diagnosis, its sensitivity is compromised, especially in paucibacillary samples. Because polymerase chain reaction (PCR) amplifies mycobacterial DNA, it is more sensitive than culture for the diagnosis of Mycobacterium tuberculosis (Mtb). However, its performance can be affected by intrinsic sample inhibitors and by the extraction/detection techniques used. METHODS: We evaluated the influence of preanalytical conditions on Mtb detection in samples of sputum (SPU), bronchoalveolar lavage (BAL), and pleural fluid (PF) using combinations of extraction/detection methods. Respiratory samples were prepared to contain different concentrations of red blood cells and nucleated cells to which increasing amounts of Mtb colonies were inoculated and submitted to PCR. RESULTS: Up to 102 CFU/ml of Mtb were detected in the SPU in all methods, except for the Roche extraction/detection method, regardless of the preanalytical sample condition. In BAL samples, medium and high concentrations of cells and high concentrations of red blood cells contributed to a lower Mtb detection, regardless of the extraction method used. In PF, red blood cells were the variable that most interfered with Mtb detection, with better recovery (102 CFU/ml) observed with the Qiagen/Nanogen combination. CONCLUSION: The choice of Mtb extraction and detection method is of fundamental importance for PCR analytical sensitivity, especially when paucibacillary samples and/or samples containing potential PCR inhibitors are analyzed.

Estabilidad de la adenosina deaminasa en diferentes medios de transporte del líquido pleural / Adenosine deaminase stability in pleural effusions defferent means of transport

La determinación de los niveles de la adenosina deaminasa en el líquido pleural es sensible y específica para la tuberculosis pleural. La adenosina deaminasa en el líquido pleural disminuye con el tiempo a temperatura ambiente. El objetivo de este estudio es demostrar si existe diferencia en los valores de la adenosina deaminasa en líquidos pleurales en cuatro medios diferentes de transporte (hielo, citrato de sodio, heparina y ninguna sustancia, química añadida). Se determinaron los niveles de la enzima en ochenta y ocho (88) muestras de líquido pleural procedentes de 22 pacientes con derrames pleurales no diagnosticados. Se demostró la concordancia diagnóstica entre los diferentes medios de transporte. No se demostró diferencia significativa entre los niveles de la adenosina deaminasa en cada una de los diferentes medios de transporte hasta dos (2) horas posterior a su recolección. Se recomienda enviar las muestras de líquido pleural con el conservativo adecuado o con ácido etilen diamino tetracético de rutina en nuestro país

The determination of the levels of adenosine deaminase in pleural fluid is sensitive and specific for pleural tuberculosis. Adenosine deaminase in pleural fluid decreases over time at room temperature. The objective of this study is to demostrate if there is difference on the average values of adenosine deaminasa in pleural fluids in four different means of transport (ice, sodium citrate, heparin and no added chemical substance). The levels of the enzyme in eighty-eight (88) pleural fluid samples from 22 patients with diagnosed pleural effusions were determined. We demonstrated diagnostic concodance between the differents modes of transport. No significant difference is between the levels of adenosine deaminase in each of the different means of transport up to two (2) hours after collection. It is recommended to send by routine in our country samples of pleural fluid with the right conservative or Acid etilen diamino tetracetic

Características morfo-citoquímicas del líquido pleural: estudio de 104 casos / Morph-cytochemical characteristics of the pleural effusion: study of 104 cases

El objetivo del trabajo es analizar las características morfo-citoquímicas de los líquidos pleurales, de pacientes con derrame pleurales, para proporcionar métodos útiles de diagnóstico etiológico. Se extrajeron entre 10 y 50 ml. de líquido pleural de 104 pacientes. Los líquidos pleurales se clasificaron en exudados y trasudados. Se practicó estudio morfo-citoquímico, citología, coloración de Ziehl-Neelsen y cultivo para bacilo de Koch, hongos y biopsia. La distribución de los derrames pleurales fue: tuberculosos (n=36-35,0%); neoplásicos (n=28-27,0%); indeterminados (n=18-17,3%) infecciones respiratorias (11,0%); insuficiencia renal (7,0%) y otros. El 84,0% de los derrames pleurales fue de tipo exudado. El 50,0% de los líquidos pleurales hemorrágicos fueron neoplásicos. En los derrames pleurales de tipo exudado hubo una predominancia de linfocitos/polimorfonucleares. La coloración de Ziehl-Neelsen resultó siempre negativa. Los cultivos fueron positivos para bacilo de koch (10,0%). En el 17,9% se diagnosticaron derrames pleurales neoplasicos. Concluimos, que las características morfo-citoquímicas del líquido pleural son importantes para hacer un diagnóstico etiológico del derrame pleural aun cuando se disponga de métodos más actualizados

The objective of the study is to analyze the characteristics of pleural fluid patients with pleural effusions to provide useful methods of etiological diagnosis. It was extracted between 10 and 50 ml pleural fluid 104 patients. The pleural fluids were classified in transudates and exudates. Was precticed morph-cytochemical, cytology, staib of Ziehl-Neelsen and cultivation for Koch's bacilli and fungi and biopsy. The distribution of the pleural effusions was: tuberculosis (n=36-35.0%); neoplastic (n=28-27.0%), indeterminate (n=18-7.3%) respiratory infections (n=18-17.3%); kidney failure (7,0%) and others. The 84.0% of the pleural fluids was exudates type. The 50.0% of bleeding pleural fluids were neoplastic. There was a predominance of lymphocytes/polymorphonuclears in the pleural effusions of exudates type; the stain of Ziehl-Neelsen was always negative. The cultures were positive for Koch's bacilli (10.0%). Neoplastic effusions were diagnosed at 17.0%. We conclude that the morph-cytochemical features of the pleural fluid are important making a diagnosis etiological effusion even when most up-to-date methods are available

Utilidad de los marcadores tumorales en líquidos de punción pleural / Usefulness of tumor markers in pleural fluids

El diagnóstico de la neoplasia pleural se basa en la demostración de células neoplásicas en fluido pleural (FP) o en biopsias de pleura. Sin embargo, aún en casos de malignidad hay un elevado porcentaje de informes falsos negativos (30-60%). Los FP neoplásicos presentan valores detectables de marcadores tumorales (MT) producidos por las células neoplásicas de la pleura. El objetivo de este trabajo ha sido evaluar la utilidad diagnóstica de algunos marcadores tumorales, de uso corriente en el laboratorio, en los fluidos de punción pleural. En 20 de ellos se analizaron: Antígeno cárcinoembrionario (CEA), fragmentos de la citoqueratina 19 (CYFRA 21-1) y Antígeno CA 125. Se efectuó el estudio fisicoquímico, recuento celular y examen citológico (Papanicolaou). En algunos casos se realizó diagnóstico anátomo-patológico. Los MT se dosaron por inmunoensayo de electroquimioluminiscencia. La comparación se efectuó por Kruskal-Wallis. Las muestras fueron clasificadas en 4 grupos y se determinó en cada uno mediana y rango para CEA (ng/mL), CYFRA (ng/mL) y CA 125 (UI/mL), respectivamente: 1) Citología positiva con diagnóstico previo de cáncer de pulmón (n: 5) 112 (2,3-1.610), 134,4 (45,8-600), 1.048 (498-2999); 2) Citología positiva con diagnóstico previo de cáncer de otro origen (n: 4) 15,28 (1,1-93,80), 108,1 (7,42-497,2), 1.827 (1.103-14.130); 3) Citología negativa con diagnóstico incierto (n: 4) 1,89 (0,91-2,96), 17,1 (1,5-29,6), 578,2 (27,8-12); 4) Citología no concluyente con diagnóstico incierto (n: 7) 31,8 (1,28-370,2), 96,3 (23,8-860), 585 (94,4-4.584). Se observó diferencia significativa entre los grupos. La combinación de citología y MT aumentó el diagnóstico de neoplasia pleural en 25%. Los resultados preliminares permiten concluir que un panel de marcadores tumorales en FP, sumado a los estudios tradicionales, representa una ayuda diagnóstica.

The diagnosis of pleural cancer is supported by the demonstration of neoplastic cells in pleural fluid or in pleural biopsies. However, even in malignancy there are a great number of false negatives results (30-60%). Tumor fluids. To establish the value of different tumor markers, frequently used in clinical laboratories, in the diagnosis of pleural fluids. 20 pleural fluids were processed for physical and chemical study, cellular counting, morphological examination (Papanicolaou stain) and electrochemiluminescense immunoassay for carcinoembryonic antigen (CEA), CYFRA 21-1 and CA 125. The results were analysed by Kruskal-Wallis. In some cases, biopsies were performed. The samples were classified in four groups, and the median and rank were calculated in each case (CEA, CYFRA and CA 125). 1) Positive cytology with previous diagnosis of lung cancer (n: 5) 112 (2.3-1610), 134.4 (45.8-600), 1048 (498-2999) 2) Positive cytology with previous diagnosis of not-lung cancer(n: 4) 15.28 (1.1-93.80), 108.1 (7.42- 497.2),1827 (1103-14130), 3) Negative cytology with uncertain diagnosis (n: 4)1.89 (0.91- 2.96), 17.1 (1.5-29.6), 578.2 (27.8-12, 4) Inconclusive cytology with uncertain diagnosis (n: 7) 31.8 (1.28-370.2), 96.3 (23.8-860), 585 (94.4 -4584). There were stastistic differences among the four groups. Joining the cytology to the assays for tumor markers raised sensitivity by 25%. The assay for tumor markers can be a complementary tool in the diagnosis of effusions.

Malignant and tuberculous pleural effusions: immunophenotypic cellular characterization

INTRODUCTION AND OBJECTIVES: Tuberculosis and cancer are the main causes of pleural effusion. Pleural involvement is associated with migration of immune cells to the pleural cavity. We sought to characterize the immunophenotype of leukocytes in the pleural effusion and peripheral blood of patients with tuberculosis or malignancy. METHODS: Thirty patients with tuberculosis (14) or malignancy (16) were studied. A control group included 20 healthy blood donors. RESULTS: Malignant phycoerythrin pleural effusions showed higher percentages of CD3, CD4, CD3CD45RO, and CD20CD25 lymphocytes and lower percentages of CD3CD25 and CD20HLA-DR when compared to PB lymphocytes. Compared to PB, tuberculous effusions had a higher percentage of lymphocytes that co-expressed CD3, CD4, CD3CD45RO, CD3TCRáâ, CD3CD28, and CD20 and a lower percentage of CD14, CD8 and CD3TCRãä-positive lymphocytes. Malignant effusions presented higher expression of CD14 whereas tuberculous effusions had higher expression of CD3 and CD3CD95L. Peripheral blood cells from tuberculosis patients showed higher expression of CD14, CD20CD25 and CD3CD95L. Compared with the control cells, tuberculosis and cancer peripheral blood cells presented a lower percentage of CD3CD4 and CD3CD28-positive cells as well as a higher percentage of CD3CD8, CD3CD25 and CD3CD80-positive cells. CONCLUSIONS: Tuberculous and malignant peripheral blood is enriched with lymphocytes with a helper/inducer T cell phenotype, which are mainly of memory cells. CD14-positive cells were more frequently found in malignant effusions, while CD3-positive cells expressing Fas ligand were more frequently found in tuberculous effusions.

Diagnóstico diferencial del derrame pleural a través de los valores de corte de los parámetros bioquímicos del líquido / Differential diagnosis of pleural effusion assessed by cut off values of biochemical pleural fluid tests

Objective: The aim of biochemical pleural fluid testing is to reach an etiological diagnosis of the pleural effusion. We assessed the utility of considering cut-off points for the wide range of analyses used to investigate pleural fluid. Patients and methods: Among 1 586 patients with pleural effusion, we sought the etiologies of those fluids which showed any of the following characteristics: red blood cell count ≥ 10 x 109 l, leukocytes ≥ 10 x 109 /l, percentage of neutrophils or lymphocytes > 50%, protein ≥ 30 and 50 g/l, glucose ≤ 60 mg/dl, pH ≤ 7.20, lactate dehydrogenase ≥ 1 000 U/l, adenosine deaminase ≥ 40 U/l, amylase ≥ 100 U/l or cholesterol ≥ 40 and 60 mg/dl. Results: Some of the more prominent findings were: 1) 15% and 18% of transudates were blood-tinged or contained predominantly neutrophils respectively, 2) a grossly bloody fluid suggests malignant disease, trauma, pulmonary embolization or pneumonia, 3) nearly 80% of fluids containing > 10 x 109 / leukocytes/l were parapneumonics, 4) 72% of tuberculous pleural fluids had protein > 50 g/l, 5) tuberculosis and parapneumonics explained 90% of fluids with high adenosine deaminase content, 6) one third of amylase-rich pleural effusions were malignant, 7) a low pleural glucose or pH levels indicates a parapneumonic and, less frequently a tuberculous or malignant etiology, 8) the overall diagnostic yield of pleural fluid cytology in malignant effusions was 61%, a percentage which exceeded 80% in those with low pH or glucose fluid levels. Conclusions: Cut-off values of biochemical pleural fluid

Objetivo: Evaluar la utilidad de diversos valores de corte aplicados a una gran variedad de parámetros bioquímicos del líquido pleural para identificar la causa de un derrame pleural. Pacientes y métodos: En 1 586 pacientes con derrame pleural se analizaron las causas de aquellos líquidos que presentaban alguna de las siguientes características: hematíes ≥ 10 x 109/l, leucocitos ≥ 10 x 109/l, porcentaje de neutrófilos o linfocitos > 50%, proteínas ≥ 30 y 50 g/l, glucosa ≤ 60 mg/dl, pH ≤ 7.20, lactato deshidrogenasa ≥ 1 000 U/l, adenosina desaminasa ≥ 40 U/l, amilasa ≥ 100 U/l o colesterol ≥ 45 y 60 mg/dl. Resultados: Algunos de los hallazgos más destacados fueron: 1) 15% y 18% de los trasudados eran sanguinolentos o tenían celularidad de predominio neutrofílico, respectivamente; 2) un derrame francamente hemático sugiere malignidad, traumatismo, embolia pulmonar o neumonía; 3) cerca del 80% de muestras de líquidos con más de 10 x 109 leucocitos/l eran paraneumónicas; 4) el 72% de los líquidos tuberculosos tenían cifras de proteínas ≥ 50 g/l; 5) los derrames tuberculosos y paraneumónicos explican el 90% de los líquidos con concentraciones elevadas de adenosina desaminasa; 6) un tercio de los derrames ricos en amilasa son malignos; 7) cifras bajas de glucosa o pH pleurales indican que el paciente probablemente tiene un derrame paraneumónico o, en menos ocasiones, tuberculoso o maligno; 8) la rentabilidad global de la citología en los derrames malignos fue del 61%, porcentaje que superó el 80% en los líquidos con concentraciones bajas de pH o glucosa. Conclusiones: La consideración de determinados valores de corte de los parámetros bioquímicos del líquido pleural puede apoyar fuertemente algunas etiologías de derrame pleural

O tubo de silicone como dreno torácico em eqüinos

The acute thorax syndrome is common in horses and has a high mortality rate. The development of more efficient treatment regimens will certainly account for an increased number of successful outcomes. The purpose of this research was to evaluate the silicon tube’s complacency, draining ability and radiopacity when used as a thoracic drain in horses. Changes in physiologic parameters, blood cell count and pleural fluid were also investigated. Ten horses of different breeds, body weight and age were used and the silicon tube was placed in the pleural cavity by means of a trocar, with the horse under sedation and local anesthesia. Following introduction and placement in the ventral portion of the cavity, the tube was connected to an intravenous set and closed with a triple valve. Vital functions were monitored and blood cell count, plasmatic fibrinogen and pleural fluid were analysed. Data were evaluated by statistical multivariate analysis. Conclusions were: the silicon tube has good draining ability and maintains its consistency in contact with the pleural fluid; tube complacency can be affected; the tube has good radiopacity.

O tórax agudo possui ocorrência comum em eqüinos, e é responsável por alta mortalidade. Diante disso, o aprimoramento dos meios de tratamento certamente contribuirá para o maior índice de sobrevivência desses animais. Para tanto, este estudo teve a finalidade de avaliar: a complacência, capacidade de drenagem e a radiopacidade de tubo de silicone quando utilizado como dreno torácico em eqüinos e, as possíveis alterações causadas nas variáveis fisiológicas, no hemograma e no líquido pleural. O tubo de silicone foi introduzido na cavidade pleural de 10 eqüinos hígidos através de trocarte, mediante sedação dos animais e anestesia local. Após introdução e posicionamento, o tubo foi conectado a equipo de infusão e tampado por torneira de três vias. Avalioaram-se as variáveis fisiológicas dos animais, analisaram-se o hemograma, o fibrinogênio plasmático e o líquido pleural durante 15 dias. Os dados obtidos foram confrontados estatisticamente pela análise de variância. Concluiu-se que o tubo de silicone permite drenagem satisfatória; mantém sua consistência inalterada na presença do líquido pleural; é radiopaco ao exame radiográfico e é passível de alterar sua complacência na presença de vácuo.

O tubo de silicone como dreno torácico em eqüinos

The acute thorax syndrome is common in horses and has a high mortality rate. The development of more efficient treatment regimens will certainly account for an increased number of successful outcomes. The purpose of this research was to evaluate the silicon tubes complacency, draining ability and radiopacity when used as a thoracic drain in horses. Changes in physiologic parameters, blood cell count and pleural fluid were also investigated. Ten horses of different breeds, body weight and age were used and the silicon tube was placed in the pleural cavity by means of a trocar, with the horse under sedation and local anesthesia. Following introduction and placement in the ventral portion of the cavity, the tube was connected to an intravenous set and closed with a triple valve. Vital functions were monitored and blood cell count, plasmatic fibrinogen and pleural fluid were analysed. Data were evaluated by statistical multivariate analysis. Conclusions were: the silicon tube has good draining ability and maintains its consistency in contact with the pleural fluid; tube complacency can be affected; the tube has good radiopacity.

O tórax agudo possui ocorrência comum em eqüinos, e é responsável por alta mortalidade. Diante disso, o aprimoramento dos meios de tratamento certamente contribuirá para o maior índice de sobrevivência desses animais. Para tanto, este estudo teve a finalidade de avaliar: a complacência, capacidade de drenagem e a radiopacidade de tubo de silicone quando utilizado como dreno torácico em eqüinos e, as possíveis alterações causadas nas variáveis fisiológicas, no hemograma e no líquido pleural. O tubo de silicone foi introduzido na cavidade pleural de 10 eqüinos hígidos através de trocarte, mediante sedação dos animais e anestesia local. Após introdução e posicionamento, o tubo foi conectado a equipo de infusão e tampado por torneira de três vias. Avalioaram-se as variáveis fisiológicas dos animais, analisaram-se o hemograma, o fibrinogênio plasmático e o líquido pleural durante 15 dias. Os dados obtidos foram confrontados estatisticamente pela análise de variância. Concluiu-se que o tubo de silicone permite drenagem satisfatória; mantém sua consistência inalterada na presença do líquido pleural; é radiopaco ao exame radiográfico e é passível de alterar sua complacência na presença de vácuo.