Sonographically guided thoracentesis and rate of pneumothorax

Barnes, David J.; Morgenthaler, Timothy I.; Olson, Eric J.; Hesley, Gina K.; Decker, Paul A.; Ryu, Jay H.

doi:10.1002/jcu.20163

Cited by 149 publications

(111 citation statements)

References 19 publications

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“…However, due to the broad CI and small number of cases (three cases in the pneumothorax group), further studies evaluating dry tap as a risk factor for pneumothorax are required to clarify this issue. Many previous studies have reported the utility of ultrasound guidance in reducing the risk of iatrogenic pneumothorax (6,(21)(22)(23)(24). However, we did not observe an association between the use of ultrasound guidance and pneumothorax.…”

Section: Discussioncontrasting

confidence: 90%

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

Cho

Choi

et al. 2017

J. Thorac. Dis.

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Background: There is a lack of data regarding the incidence and associated factors of pneumothorax following thoracentesis conducted in emergency department (ED) settings. The present study aims to determine the incidence of pneumothorax following thoracentesis in ED settings and evaluate the association of specific demographics, clinical, and procedure factors with thoracentesis-related pneumothorax. Methods:We retrospectively reviewed the medical records of 3,067 thoracentesis cases in the ED of a tertiary care, university-affiliated hospital between January 2009 and December 2014. To evaluate the factors associated with the occurrence of pneumothorax following thoracentesis, matched controls were used with a case to control ratio of 1:5. Results: Of the 3,067 cases that received thoracentesis, 19 cases of pneumothorax were observed (0.62%).Patients with pneumothorax had significantly lower weight and body mass index (BMI) than those without pneumothorax (51.0 vs. 61.2 kg, 20.0 vs. 22.6; P<0.001, respectively). In the multivariate logistic regression analysis, being underweight, defined as a BMI of <18.5 [OR, 5.2 (95% CI, 1.3-21.2); P=0.021] was significantly associated with the occurrence of pneumothorax. Conclusions:The incidence of pneumothorax following thoracentesis was very low in the present study. However, clinicians should be aware of the risk of pneumothorax in underweight patients during thoracentesis. Further prospective studies are required to clarify the results of the present study.

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Section: Discussioncontrasting

confidence: 90%

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

Cho

Choi

et al. 2017

J. Thorac. Dis.

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“…In contrast, the pneumothorax rate associated with ultrasound-guided thoracenteses was lower, ranging from 0 to 9.1%. The rates of subsequent chest tube insertion for pneumothoraces ranged from 2.2-7% in those procedures without ultrasound guidance and 0-3.7% in procedures performed with ultrasound guidance [6,13,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Overall Incidence Of Pneumothorax and Impact Of Ultrasoundmentioning

confidence: 99%

Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure

Sikora

Perera

Mailhot

et al. 2012

ISRN Emergency Medicine

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Objective. To review the use of ultrasound for the detection of pleural effusions and guidance of the thoracentesis procedure. Methods. Two clinical cases will be presented in which ultrasound proved beneficial in guiding the diagnosis and management of patients with pleural effusions and respiratory distress. The ultrasound techniques for the evaluation of pleural effusions and performance of the thoracentesis procedure are discussed. A review of the most current literature follows to present the known diagnostic and safety benefits of ultrasound guidance for thoracentesis. Conclusions. Ultrasound improves the diagnostic accuracy for the detection of pleural effusions over standard chest radiographs. Ultrasound can also diagnose a complicated pleural effusion that may be at higher risk for an adverse outcome during a thoracentesis. Optimally, thoracentesis should be performed under direct ultrasound guidance to decrease the complication rate and improve patient safety.

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“…Additionally thoracentesis can be performed under ultrasound guidance (7,8). Further advantages of chest ultrasound are low costs, lack of radiation exposure, and userfriendliness.…”

mentioning

confidence: 99%

Bedside diagnosis of pleural effusion with a latest generation hand-carried ultrasound device in intensive care patients

Schleder¹,

Dornia²,

Poschenrieder³

et al. 2012

Acta Radiol

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Background: Further development established hand-carried ultrasound (HCU) imagers in daily clinical workflow providing several advantages such as fast bedside availability and prompt diagnosis. Purpose: To evaluate the diagnostic yield of a latest generation HCU imager compared to chest radiography (CR) for the detection of pleural effusion (PE) in intensive care patients. Material and Methods: Forty-eight hemithoraces of 24 patients on surgical intensive care units were enrolled in this study. All hemithoraces were evaluated using both HCU and CR. Definite diagnosis of PE was achieved using a high-end ultrasound system as standard of reference. Statistical analysis was performed using 2 Â 2 tables and a McNemar test. A P value of ,0.05 was considered statistically significant. Results: PE was present in 35 of 48 hemithoraces (73%). The HCU examination was carried out technically successfully in all hemithoraces. Sensitivity and specificity of HCU for the diagnosis of PE was 91% and 100%, respectively, whereas sensitivity and specificity of CR was 74% and 31%, respectively. The difference between HCU and CR was statistically significant with respect to specificity but not sensitivity (P ¼ 0.008 and P ¼ 0.11, respectively). Conclusion: Due to its ease of use and its high diagnostic yield HCU systems of the latest generation constitute a helpful technique for the primary assessment of PE.

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Sonographically guided thoracentesis and rate of pneumothorax

Abstract: The routine use of sonography during diagnostic thoracentesis is associated with a reduced rate of pneumothorax and tube thoracostomy.

Cited by 149 publications

References 19 publications

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

Incidence and risk factors of iatrogenic pneumothorax after thoracentesis in emergency department settings

Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure

Bedside diagnosis of pleural effusion with a latest generation hand-carried ultrasound device in intensive care patients

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