Thoracentesis

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Revision as of 16:16, 8 April 2010 by imported>Robert Badgett (Added catheter to the procedure)
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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).