pleural effusion

[drgovindh]

I am currently posted in the chest ward and i have a number of patients with ICD. I know pretty well that with expiration the intra pleural pressure rises up. Does that rise a factor responsible for the draining of fluid into the ICD. OR is it the inspiratory exercises which expand the lung which compresses the pleural space help in draining of the fluid?

Please reply

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[sdkashif]

Venting of container, used in ICD, to atmosphere, allows fluid to drain by gravity. Air flow is governed by the relationship of intrapleural pressure to atmospheric pressure. When the pressure in the pleural cavity is below atmospheric pressure (during inspiration), the water level will rise slightly in the water seal and when the pressure is above the atmospheric pressure ( during expiration ), air will flow into the drainage container.

[fire_ice]

helo,
i dont think that what ever u r saying is right u have mis understood the concept,let me give it a try..
at the end if the expiration the intra pleural pressure is more negative that the intra thoracic pressure coz of the elastic recoil that pulls the alveoli inwards, at the beginning of the inspiration when the inspiratory muscles contract they further reduce the intra pleural pressure and the intra thoracic pressure causing the air to move in from the outside, as the inspiration continues both the intra pleural and the intra thoracic pressure begins to rise such that at the end of the inspiration both the intra pleural and the intra thoracic pressure are equal.
now regarding the drainage its due to the pull of gravity but the drainage can definitely be aided by using suction,or asking the patient to do any form of exercise like marching,bicycle ergometer,static walking.....and so on ,it can further be assisted by asking the patient to do bouts of coughing followed by breathing control / diaphramatic breathing.
hope this will be helpful.
regards

[jova990]

Hi, I'm trying EBM studies on effectiveness of physiotherapy treatment in pleural adhesions, can anyone help me out? thanks in advance