Safety of large-volume thoracentesis.
OBJECTIVE
To assess the risks associated with removal of more than 1 liter of pleural fluid in one settingwithout intrapleural pressure monitoring.


METHODS
Single-center retrospective chart review.


METHODS
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.


CONCLUSIONS
Large-volume thoracentesis is a safe procedure that is comparable in risk to small volume thoracentesis.
Abunasser
Jafar
J
Department of Internal Medicine, Saint Vincent's Medical Center, Bridgeport, USA.
Brown
Robert
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes; D016009:Chi-Square Distribution; D003237:Connecticut; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019152:Paracentesis / Q000009:adverse effects*; D010996:Pleural Effusion / Q000628:therapy*; D011030:Pneumothorax / Q000453:epidemiology; D011654:Pulmonary Edema / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome