Jafar Abunasser1, Robert Brown. 1. Department of Internal Medicine, Saint Vincent's Medical Center, Bridgeport, USA.
Abstract
OBJECTIVE: To assess the risks associated with removal of more than 1 liter of pleural fluid in one settingwithout intrapleural pressure monitoring. DESIGN: Single-center retrospective chart review. SETTING: Medium-sized community-based teaching hospital in Bridgeport, Connecticut. METHODS: We reviewed thoracenteses performed between February 2004 and March 2006, and documentedtherates of hypotension, pneumothorax, bleeding, andre-expansion pulmonaryedema. RESULTS: A total of 300 thoracenteses performed on 237 patients were analyzed, of which 137 were large volume (>1 liter) and 163 were small volume (<1 liter). There was no statistically significant increase in risk of pneumothorax, hypotension, or bleeding with large-volume thoracentesis. One case of radiographically-identified re-expansion pulmonary edema occurred when 2600 mL of fluid were removed. CONCLUSION: Large-volume thoracentesis is a safe procedure that is comparable in risk to small volume thoracentesis.
OBJECTIVE: To assess the risks associated with removal of more than 1 liter of pleural fluid in one settingwithout intrapleural pressure monitoring. DESIGN: Single-center retrospective chart review. SETTING: Medium-sized community-based teaching hospital in Bridgeport, Connecticut. METHODS: We reviewed thoracenteses performed between February 2004 and March 2006, and documentedtherates of hypotension, pneumothorax, bleeding, andre-expansion pulmonaryedema. RESULTS: A total of 300 thoracenteses performed on 237 patients were analyzed, of which 137 were large volume (>1 liter) and 163 were small volume (<1 liter). There was no statistically significant increase in risk of pneumothorax, hypotension, or bleeding with large-volume thoracentesis. One case of radiographically-identified re-expansion pulmonary edema occurred when 2600 mL of fluid were removed. CONCLUSION: Large-volume thoracentesis is a safe procedure that is comparable in risk to small volume thoracentesis.