title: Unilateral or Bilateral Thoracocentesis for Bilateral Pleural Effusion. A Prospective Study.
abstract: BACKGROUND
  In the absence of firm recommendations, we analyzed whether unilateral thoracic puncture is sufficient for bilateral pleural effusion (PE), or if the procedure needs to be performed in both sides.
  
  
  METHODS
  Prospective study of patients seen consecutively for bilateral PE during a period of 3 years and 9 months. All patients underwent simultaneous bilateral thoracocentesis. The standard protocol variables collected in our hospital served as study parameters. Size of PE, presence of chest pain or fever, or accompanying lung abnormalities, different attenuation values on chest computed tomography, presence of loculated pleural fluid, and radiological resolution in a single side were also evaluated.
  
  
  RESULTS
  A total of 36 patients (19 men; mean age 68.5 ± 16.5 years) were included. The etiology of the effusion was different in each side in only 2 patients (5.6%). In 6/32 cases (18.8%), the biological analysis of the pleural fluid (in terms of transudate/exudate) from both sides did not correspond with the etiological diagnosis of the effusion. Correlation between biochemical parameters analyzed in the fluid from both sides (Pearson's correlation coefficient) ranged between 0.74 (LDH) and 0.998 (NT-proBNP). As different diagnoses in each side were found in only 2 patients, the circumstances in which bilateral diagnostic thoracocentesis would be necessary could not be determined.
  
  
  CONCLUSIONS
  Simultaneous bilateral thoracocentesis does not appear to be recommendable. Larger series are needed to establish which factors might suggest the need for simultaneous puncture of both PE.
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España.
authors.forename: Lucía
authors.initials: L
authors.lastname: Ferreiro
authors.affiliation: Servicio de Análisis Clínicos, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España.
authors.forename: María Esther
authors.initials: ME
authors.lastname: San José
authors.affiliation: Unidad de Epidemiología Clínica, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Epidemiología de Enfermedades Frecuentes, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gude
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España.
authors.forename: Adriana
authors.initials: A
authors.lastname: Lama
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Suárez-Antelo
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Golpe
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España.
authors.forename: M Elena
authors.initials: ME
authors.lastname: Toubes
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: González-Barcala
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Álvarez-Dobaño
authors.affiliation: Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, La Coruña, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, La Coruña, España. Electronic address: luis.valdes.cuadrado@sergas.es.
authors.forename: Luis
authors.initials: L
authors.lastname: Valdés
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D000069258:Thoracentesis / Q000379:methods*
keywords: Bilateral diagnostic thoracocentesis; Bilateral pleural effusion; Contarini syndrome; Derrame pleural; Derrame pleural bilateral; Pleural effusion; Síndrome de Contarini; Toracocentesis diagnóstica bilateral