Complications of thoracentesis

Incidence, risk factors, and strategies for prevention

Eric P. Cantey, James M. Walter, Thomas Corbridge, Jeffrey H. Barsuk*

*Corresponding author for this work

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Purpose of review: Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent findings: Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Summary: Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.

Original languageEnglish (US)
Pages (from-to)378-385
Number of pages8
JournalCurrent Opinion in Pulmonary Medicine
Volume22
Issue number4
DOIs
StatePublished - Jul 1 2016

Fingerprint

Incidence
Pneumothorax
Pulmonary Edema
Hemorrhage
Hemothorax
Pressure
Thoracentesis
Thoracic Wall
Thrombocytopenia
Hematoma
Health Care Costs
Anticoagulants
Morbidity
Mortality

Keywords

  • hemothorax
  • iatrogenic pneumothorax
  • re-expansion pulmonary edema
  • thoracentesis
  • ultrasound

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{0c262a32c56248cabe094a31ba474d2e,
title = "Complications of thoracentesis: Incidence, risk factors, and strategies for prevention",
abstract = "Purpose of review: Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent findings: Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Summary: Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.",
keywords = "hemothorax, iatrogenic pneumothorax, re-expansion pulmonary edema, thoracentesis, ultrasound",
author = "Cantey, {Eric P.} and Walter, {James M.} and Thomas Corbridge and Barsuk, {Jeffrey H.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1097/MCP.0000000000000285",
language = "English (US)",
volume = "22",
pages = "378--385",
journal = "Current Opinion in Pulmonary Medicine",
issn = "1070-5287",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Complications of thoracentesis : Incidence, risk factors, and strategies for prevention. / Cantey, Eric P.; Walter, James M.; Corbridge, Thomas; Barsuk, Jeffrey H.

In: Current Opinion in Pulmonary Medicine, Vol. 22, No. 4, 01.07.2016, p. 378-385.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Complications of thoracentesis

T2 - Incidence, risk factors, and strategies for prevention

AU - Cantey, Eric P.

AU - Walter, James M.

AU - Corbridge, Thomas

AU - Barsuk, Jeffrey H.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Purpose of review: Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent findings: Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Summary: Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.

AB - Purpose of review: Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent findings: Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Summary: Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.

KW - hemothorax

KW - iatrogenic pneumothorax

KW - re-expansion pulmonary edema

KW - thoracentesis

KW - ultrasound

UR - http://www.scopus.com/inward/record.url?scp=84964325483&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964325483&partnerID=8YFLogxK

U2 - 10.1097/MCP.0000000000000285

DO - 10.1097/MCP.0000000000000285

M3 - Review article

VL - 22

SP - 378

EP - 385

JO - Current Opinion in Pulmonary Medicine

JF - Current Opinion in Pulmonary Medicine

SN - 1070-5287

IS - 4

ER -