First Things First
- Thoracentesis is the invasive, percutaneous access of the pleural space for removal of pleural fluid or air.
- As such, the procedure requires a written informed consent from the patient or his/her power of attorney.
- Determine the diagnosis of the etiology of a pleural effusion: suspected infection, hemothorax, or empyema; effusion not explained by clinical presentation.
- Provide therapeutic drainage of pleural effusion: large or massive effusion.
- Absolute Contraindications
- Severe hemodynamic and/or respiratory instability: treat/optimize before attempting thoracentesis.
- Severe coagulopathy (platelet count <50,000; INR >1.5; fibrinogen <100)
- Portal hypertension with coexisting pleural varices
- Infection at the site of planned thoracentesis (i.e., varicella zoster, cellulitis)
- Relative Contraindications
- Mechanical ventilation with high level of PEEP (>10 cm H2O)
- Presence of single lung (i.e., following pneumonectomy)
- Small effusion (<1 cm on lateral decubitus CXR)
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Last updated: May 5, 2010
"Thoracentesis." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534070/all/Thoracentesis.
Thoracentesis. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534070/all/Thoracentesis. Accessed June 7, 2023.
Thoracentesis. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534070/all/Thoracentesis
Thoracentesis [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2023 June 07]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534070/all/Thoracentesis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Thoracentesis ID - 534070 Y1 - 2010/05/05/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534070/all/Thoracentesis PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -