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Trapped lung
1Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. doelkenp@musc.edu
Seminars in Respiratory and Critical Care Medicine
|August 10, 2005
Summary
Trapped lung, a condition causing chronic pleural effusion, occurs when a fibrous peel restricts lung expansion. Surgical decortication is the only effective treatment for symptomatic cases.
Area of Science:
- Pulmonology
- Thoracic Surgery
Background:
- Trapped lung results from fibrinous or granulomatous pleuritis, leading to chronic, benign, unilateral pleural effusion.
- It is characterized by a restrictive fibrous visceral pleural peel preventing lung expansion and causing a fluid-filled pleural space maintained by hydrostatic equilibrium.
Purpose of the Study:
- To define trapped lung, its causes, diagnostic criteria, and treatment options.
- To differentiate trapped lung from other pleural conditions and establish management guidelines.
Main Methods:
- Review of literature on pleuritis, pleural effusion, and trapped lung.
- Analysis of diagnostic findings including negative pleural liquid pressure, increased pleural space elastance, and pleural peel visualization.
- Evaluation of treatment outcomes, focusing on surgical decortication.
Main Results:
- Trapped lung is a consequence of conditions like inadequately treated parapneumonic effusion, tuberculosis complications, cardiac surgery, or chest trauma.
- Diagnosis requires evidence of chronicity, stability, and absence of active inflammation, malignancy, or obstruction.
- Key diagnostic findings include initial negative pleural liquid pressure, increased pleural space elastance, and a demonstrable pleural peel.
Conclusions:
- Surgical decortication is the definitive therapy for symptomatic trapped lung.
- Asymptomatic patients with trapped lung require observation, not surgical intervention.
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