Portable real-time sonographic and needle guidance systems for aspiration and drainage.

One hundred and two aspiration or drainage procedures were reviewed to determine the value of portable sonographic and real-time needle guidance systems. While the majority of thoracenteses or abdominal paracenteses were performed without the aid of real-time guidance, these systems were instrumental in the development of new procedures such as percutaneous cholecystostomy and in the drainage of small fluid collections in critical areas. Portable sonographic guidance was used in 32 cases, mostly for thoracentesis or abdominal paracentesis, but it had its greatest value in guiding drainage procedures at the bedside in critically ill patients. These portable drainage procedures included four cholecystostomies, one nephrostomy, drainage of two abdominal abscesses, and two empyema drainages. Complications included one case of an enterocutaneous fistula and one case of hemoptysis after thoracentesis. The failure rate was less than 7%. The use of portable real-time sonographic and needle-guidance systems has a direct impact on improving patient care.