Evidence map›Paper›PMID 40292005›Full record

ArticleFrontiers in physiology2025

Hemidiaphragm work in large pleural effusion and its insignificant impact on blood gases: a new insight based on

Tomasz Gólczewski, Anna M Stecka, Elżbieta M Grabczak, Marcin Michnikowski, Monika Zielińska-Krawczyk, Rafał Krenke

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Article in Frontiers in physiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Tomasz GólczewskiNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.
Anna M SteckaNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.
Elżbieta M GrabczakDepartment of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Marcin MichnikowskiNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland.
Monika Zielińska-KrawczykDepartment of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
Rafał KrenkeDepartment of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Computer simulations, enabling observations of variables inaccessible in living patients, provide a powerful approach to studying complex physiological phenomena. This Methods: Inspired by unexpected phenomena observed in living patients undergoing large-volume TT, we formulated four questions regarding this impact. To answer these questions, we simulated right-sided PE in our virtual patient and studied changes in the pleural pressure in the ipsilateral hemithorax (Ppli) and lung volume during the respiratory cycle (exemplified by Ppli-V loops, where V is the volume of both lungs), airflows in the main bronchi, and alveolar O2 (PAO2) and CO2 (PACO2) partial pressures. Results: Simulations highlighted that: (a) mediastinal compliance critically affects hemidiaphragm work; (b) the 8-shaped Ppli-V loops are associated with hemidiaphragm inversion, where exhalation from the ipsilateral lung occurs during a part of both the inspiratory and expiratory phases, and vice versa; (c) pre-TT PAO2 may be elevated due to reduction of the tidal volume to end-expiratory lung volume ratio; and (d) pre-TT Ppli amplitudes during respiration can exceed post-TT values when mediastinal compliance is high. Conclusion: Our findings emphasize the significance of mediastinal compliance in pleural effusion physiology and suggest insignificant influence of the ipsilateral hemidiaphragm inverted due to large PE on arterial gas tensions. This study underscores the utility of virtual patient models for elucidating unexpected physiological behaviors and optimizing clinical interventions.

Indexed as

arterial blood gaseshemidiaphragm functionhemidiaphragm inversionin silico studylarge pleural effusionpendulum breathingtherapeutic thoracentesisvirtual patient

Identifiers

PMID40292005
PMCPMC12021632

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.