Safety of large-volume thoracentesis

Jafar Abunasser, Robert Brown
Connecticut Medicine 2010, 74 (1): 23-6

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.

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