Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:
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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)