Chest
Clinical InvestigationsPLEURAUltrasound-Guided Thoracentesis*: Is It a Safer Method?
Section snippets
Materials and Methods
After approval by the institutional review board, all patients referred to interventional radiology for a diagnostic and/or therapeutic ultrasound-guided thoracentesis between August 1997 and September 2000 were enrolled in this study and evaluated prospectively. The decision to perform ultrasound-guided thoracentesis was made by the patient’s referring physician. Symptoms as reported by the patient or complications as noted by the interventional radiologist performing the procedure were
Results
Between August 1997 and September 2000, 605 patients were enrolled in the study and underwent a total of 941 procedures. These included 668 initial procedures and 273 repeat procedures. Because of multiple procedures, it was possible for patients to appear in both groups; because of bilateral thoracenteses, there were more initial procedures than patients. The volume of fluid removed from the patients ranged from 1 to 3,800 mL (median, 800 mL). In three patients, < 10 mL fluid was removed; in
Discussion
The purpose of this study was to determine the incidence of complications with ultrasound-guided thoracentesis performed by interventional radiologists in a large patient population; to determine the necessity for prophylactic atropine; and to determine potential patient or radiographic factors that may contribute to, or be predictive of, the development of re-expansion pulmonary edema. This study demonstrates that ultrasound-guided thoracentesis, when performed by interventional radiologists,
Conclusion
In conclusion, this study demonstrates that ultrasound-guided thoracentesis by interventional radiologists is associated with a lower incidence of complications than those reported for thoracentesis without direct imaging guidance. Postthoracentesis chest radiographs should only be obtained if a pneumothorax is suspected clinically, when air is aspirated during the procedure, or when tactile fremitus is lost over the superior portion of the aspirated hemithorax. The development of pain or
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The role of an interventional pulmonologist in the management of metastatic pleural effusions (MPE)
2022, Revue des Maladies RespiratoiresSetting up a Pleural Disease Service
2021, Clinics in Chest MedicineCitation Excerpt :A study of 67 patients, prospectively identified site of puncture either using clinical decision making alone or TUS, showed 15% of the sites identified without TUS were “inaccurate” and likely to cause organ damage.32 Other studies have shown a significantly lower rate of pneumothorax when TUS is used.33 TUS can either guide the marking of a safe site at which a pleural procedure is performed or can be used to guide procedures real-time where the needle is visualized throughout.
Pleural Effusions in the Critically Ill and “At-Bleeding-Risk” Population
2021, Clinics in Chest Medicine
Supported in part by The Saint Thomas Foundation, Nashville, TN.