Safety of large-volume thoracentesis.

OBJECTIVE

To assess the risks associated with removal of more than 1 liter of pleural fluid in one settingwithout intrapleural pressure monitoring.

DESIGN

Single-center retrospective chart review.

SETTING

Medium-sized community-based teaching hospital in Bridgeport, Connecticut.

METHODS

We reviewed thoracenteses performed between February 2004 and March 2006, and documentedtherates of hypotension, pneumothorax, bleeding, andre-expansion pulmonaryedema.

RESULTS

A total of 300 thoracenteses performed on 237 patients were analyzed, of which 137 were large volume (>1 liter) and 163 were small volume (<1 liter). There was no statistically significant increase in risk of pneumothorax, hypotension, or bleeding with large-volume thoracentesis. One case of radiographically-identified re-expansion pulmonary edema occurred when 2600 mL of fluid were removed.

CONCLUSION

Large-volume thoracentesis is a safe procedure that is comparable in risk to small volume thoracentesis.