Thoracentesis

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A thoracentesis is an operative surgical procedure to " to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest."[1][2]

Procedure

Routine ultrasonography can help obtain fluid samples and reduce complications according to randomized controlled trials[3][4][5] and a systematic review.[6]

The amount of fluid sent for cytology should be at least 60 mL if only direct smear/cytospin is used; whereas 150 mL should be sent if both direct smear/cytospin and cell block preparations are used.[7]

Although an over-the-needle catheter is recommended by some experts[2], it does not clearly reduce the rate of pneumothorax.[5]

Complications

The rote of pneumothorax is about 6%.[6]

Correction of coagulopathy is not required.[8]

References

  1. MedlinePlus Medical Encyclopedia: Thoracentesis. National Library of Medicine. Retrieved on 2008-06-23.
  2. 2.0 2.1 Thomsen TW, DeLaPena J, Setnik GS (October 2006). "Videos in clinical medicine. Thoracentesis". N. Engl. J. Med. 355 (15): e16. DOI:10.1056/NEJMvcm053812. PMID 17035643. Research Blogging. Cite error: Invalid <ref> tag; name "pmid17035643" defined multiple times with different content
  3. Kohan JM, Poe RH, Israel RH, et al (June 1986). "Value of chest ultrasonography versus decubitus roentgenography for thoracentesis". Am. Rev. Respir. Dis. 133 (6): 1124–6. PMID 3521416[e]
  4. Diacon AH, Brutsche MH, Solèr M (February 2003). "Accuracy of pleural puncture sites: a prospective comparison of clinical examination with ultrasound". Chest 123 (2): 436–41. PMID 12576363[e]
  5. 5.0 5.1 Grogan DR, Irwin RS, Channick R, et al (April 1990). "Complications associated with thoracentesis. A prospective, randomized study comparing three different methods". Arch. Intern. Med. 150 (4): 873–7. PMID 2183735[e] Cite error: Invalid <ref> tag; name "pmid2183735" defined multiple times with different content
  6. 6.0 6.1 Gordon CE, Feller-Kopman D, Balk EM, Smetana GW (2010). "Pneumothorax following thoracentesis: a systematic review and meta-analysis.". Arch Intern Med 170 (4): 332-9. DOI:10.1001/archinternmed.2009.548. PMID 20177035. Research Blogging.
  7. Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L et al. (2010). "Prospective study to determine the volume of pleural fluid required to diagnose malignancy.". Chest 137 (1): 68-73. DOI:10.1378/chest.09-0641. PMID 19741064. Research Blogging.
  8. Hibbert RM, Atwell TD, Lekah A, Patel MD, Carter RE, McDonald JS et al. (2013). "Safety of ultrasound-guided thoracentesis in patients with abnormal preprocedural coagulation parameters.". Chest 144 (2): 456-63. DOI:10.1378/chest.12-2374. PMID 23493971. Research Blogging.

External links

Thoracentesis - Information for patients from MedlinePlus (United States National Library of Medicine).