Background:

Pleural fibrosis and restriction are well-known complications of tuberculous pleurisy, which is often accompanied by respiratory distress and limitation of daily life activities.

Objectives:

Current evidence suggests that pleural drainage offers little benefit over and above antituberculous treatment in improving pulmonary function. Our study aims to define the role of additional pleural drainage in the management of tuberculous pleural effusions.

Methods:

We enrolled 21 patients with tuberculous effusions and performed therapeutic drainage in 10 randomly selected cases. Pulmonary function testing, exercise capacity, chest radiography, and ultrasonography were performed at baseline, 7 to 10 days, and at 3 months.

Results:

Complete therapeutic drainage was achieved in 4 of 10 patients randomized to undergo drainage. Immediate benefit in total lung capacity (TLC) was achieved in the 10 patients assigned to intervention. Intervention group showed significant changes compared to the non-intervention group in several functional parameters at 3 months: change in forced vital capacity (ΔFVC 1.40 L, 95% confidence interval [CI] 1.08-1.71 vs Δ0.34 L, 95% CI 0.01-0.67, P < .000), change in forced expiratory volume in 1 second (ΔFEV₁ 1.08 L, 95% CI 0.79-1.37 vs Δ0.38 L, 95% CI 0.08-0.68, P = .001), change in TLC (ΔTLC 1.45 L, 95% CI 1.05-1.85 vs Δ0.56 L, 95% CI 0.00-1.12, P = .009), and change in diffusion capacity for carbon monoxide (ΔDLCO 6.43 mL/min/mm Hg, 95% CI 3.73-9.12 vs Δ0.57 mL/min/mm Hg, 95% CI 2.31-3.34, P = .005). Significant improvement after 3 months was not observed in the 6-minute walking distance as well as oxygen saturation before and after walking.

Conclusion:

Therapeutic drainage may offer additional short-term functional benefits to patients with pleural tuberculosis.

Search results

The Effect of Pleural Drainage on Pulmonary Function Testing in Patients With Tuberculous Pleural Effusions