Thoracentesis: Difference between revisions

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(Added catheter to the procedure)
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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.<ref name="pmid19741064">{{cite journal| author=Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L et al.| title=Prospective study to determine the volume of pleural fluid required to diagnose malignancy. | journal=Chest | year= 2010 | volume= 137 | issue= 1 | pages= 68-73 | pmid=19741064  
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.<ref name="pmid19741064">{{cite journal| author=Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L et al.| title=Prospective study to determine the volume of pleural fluid required to diagnose malignancy. | journal=Chest | year= 2010 | volume= 137 | issue= 1 | pages= 68-73 | pmid=19741064  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19741064 | doi=10.1378/chest.09-0641 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19741064 | doi=10.1378/chest.09-0641 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref>
Although a catheter is recommended by some expertsref  name="pmid17035643">{{cite  journal |author=Thomsen TW, DeLaPena J, Setnik GS |title=Videos  in clinical medicine. Thoracentesis |journal=N. Engl. J. Med.  |volume=355 |issue=15 |pages=e16 |year=2006 |month=October  |pmid=17035643 |doi=10.1056/NEJMvcm053812 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17035643  |issn=}}</ref>, it does not clearly reduce the rate of pneumothorax.<ref name="pmid2183735">{{cite journal| author=Grogan DR, Irwin RS, Channick R, Raptopoulos V, Curley FJ, Bartter T et al.| title=Complications associated with thoracentesis. A prospective, randomized study comparing three different methods. | journal=Arch Intern Med | year= 1990 | volume= 150 | issue= 4 | pages= 873-7 | pmid=2183735
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=2183735 }} </ref>


==Complications==
==Complications==

Revision as of 17:16, 8 April 2010

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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]

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.[6]

Although a catheter is recommended by some expertsref name="pmid17035643">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. </ref>, it does not clearly reduce the rate of pneumothorax.[5]

Complications

The rote of pneumothorax is about 6%.[7]

References

  1. ↑ MedlinePlus Medical Encyclopedia: Thoracentesis. National Library of Medicine. Retrieved on 2008-06-23.
  2. ↑ 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.
  3. ↑ 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]
  4. ↑ 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. ↑ 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] Cite error: Invalid <ref> tag; name "pmid2183735" defined multiple times with different content
  6. ↑ 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.
  7. ↑ 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.

External links

Thoracentesis - Information for patients from MedlinePlus (United States National Library of Medicine).

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