title: Pneumothorax after thoracentesis in chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To determine whether the frequency of pneumothorax is increased after thoracentesis in chronic obstructive pulmonary disease patients.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Northeastern community hospital.
  
  
  METHODS
  One-hundred-six patients underwent multiple thoracentesis; 36 patients had co-existent chronic obstructive pulmonary disease (mean age, 68.2 years). Chronic obstructive pulmonary disease was identified by radiologic findings consistent with chronic obstructive pulmonary disease and as forced expiratory volume in one second less than 70% of predicted.
  
  
  METHODS
  Identification of pneumothorax on chest roentgenogram after thoracentesis.
  
  
  METHODS
  Patients had diagnostic or therapeutic thoracentesis with follow-up chest radiography within 2 hours, or sooner if clinically indicated.
  
  
  RESULTS
  Patients with chronic obstructive pulmonary disease had a higher incidence of pneumothorax (15 of 36 patients; 41.7%) than those patients without underlying chronic obstructive pulmonary disease (13 of 70 patients; 18.5%; p = 0.005). The frequency of pneumothorax was no different according to who performed the procedure (house staff or pulmonologist), whether it was for diagnostic or therapeutic reasons, and whether a small (< 500 ml) or large (> 500 ml) amount of fluid is removed.
  
  
  CONCLUSIONS
  Pneumothorax may frequently occur in patients with chronic obstructive pulmonary disease undergoing thoracentesis. The reason may be related to the altered architecture of the lung parenchyma and the change in mechanical forces in chronic obstructive pulmonary disease. Sonography-guided thoracentesis may offer a safer means of performing thoracentesis in patients with chronic obstructive pulmonary disease.
authors.affiliation: New Rochelle Hospital Medical Center, New Rochelle, N.Y.
authors.forename: R D
authors.initials: RD
authors.lastname: Brandstetter
authors.forename: M
authors.initials: M
authors.lastname: Karetzky
authors.forename: R
authors.initials: R
authors.lastname: Rastogi
authors.forename: J D
authors.initials: JD
authors.lastname: Lolis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology*; D011446:Prospective Studies; D013396:Suction / Q000009:adverse effects*