Thoracentesis
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
- ↑ MedlinePlus Medical Encyclopedia: Thoracentesis. National Library of Medicine. Retrieved on 2008-06-23.
- ↑ 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.
- ↑ 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]
- ↑ 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]
- ↑ 5.0 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]
- ↑ 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.
- ↑ 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.
- ↑ 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.