Novel pleural lavage biosampling during thoracic surgery procedures facilitate advanced pleural fluid studies in patients with pulmonary diseases

BACKGROUND: Lung diseases are frequently associated with pleural changes. However, few is known about the pleural fluid in individuals without pleural effusions. Pleural lavage is a technique where physiological saline solution is instilled into the pleural space to obtain diluted pleural fluid. The aim of the study was to analyze the sampling, safety and feasibility of pleural lining fluid collection upon pleural lavage.

METHODS: We obtained informed consent from 185 patients with lung/pleural diseases undergoing thoracic surgery (03/2023-03/2024). Upon opening of the thoracic cavity an initial pleural lavage with 100-150 ml physiological saline solution was performed in patients without pleural effusions. Native pleural effusions were sampled as control group. Urea measurements in pleural effusion and pleural lavage were performed and compared to serum urea levels to determine the dilution factor of the pleural lining fluid, as previously described.

RESULTS: Thirty-five patients (18,9%) had an initial pleural effusion, while 150 patients (81,1%) had no pleural effusion. Of 150 patients undergoing pleural lavage upon opening of the thoracic cavity, 54 (36%) patients experienced a pleural affection. Typically, 3-15 ml of pleural lining fluid were obtained when performing a pleural lavage, as calculated by the urea dilution method. No complications associated with pleural lavage fluid sampling were observed.

CONCLUSION: Intraoperative pleural lavages are novel biosamples collected during thoracic surgery. The biosampling is feasible and safe. Investigations of pleural lining fluid will broaden our biomolecular understanding of the pleura biology and physiology and facilitate the development of novel pleural biomarkers.

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Artikel online veröffentlicht:
18. März 2025