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Thoracentesis
- See Also
- Pleural Effusion
- Pleural Effusion Causes
- Pleural Fluid Interpretation
- Indications
- Effusion >10 mm thick
- Based on lateral decubitus XRay or Ultrasound
- Effusion not explained by other cause
- CHF not responding within 3 days to diuresis
- Asymmetric Pleural Effusions
- Fever
- Effusion >10 mm thick
- Safety
- Ultrasound-guided thoracentesis has less complications
- Contraindications
- Local cutaneous condition
- Severe Coagulopathy
- ProTime or Partial Thromboplastin Time twice normal
- Platelet Count <25,000
- Creatinine > 6 mg/dl
- Chest XRay with mediastinal shift toward effusion
- Suggests negative pleural pressure
- Suggests bronchial obstruction
- Bronchoscopy recommended in these cases
- Complications
- Pneumothorax (11%)
- Requires Chest Tube in 2%
- Increased risk in COPD
- Decreased risk with experienced clinician
- Decreased risk with Ultrasound Guidance
- Cough
- Chest Pain
- Vasovagal Syncope
- Infection (2%)
- Hemothorax
- Pneumothorax (11%)
- Precautions
- Limit fluid removal to 1500 cc
- Follow-up: Post-procedure Chest XRay Indications
- Post-procedure symptoms (Chest Pain, Dyspnea)
- Signs of Pneumothorax post-procedure
- Voice transmission absent superior to thoracentesis
- Tactile fremitus absent superior to thoracentesis
- Interpretation
Thoracentesis (C0189477) | |
|---|---|
| Definition (NCI) | (thor-a-sen-TEE-sis) Removal of fluid from the pleural cavity through a needle inserted between the ribs. |
| Concepts | Diagnostic Procedure (T060) , Therapeutic or Preventive Procedure (T061) |
| ICD9 | 34.91 |
| English | Chest aspiration, Paracentesis of chest, Pleural aspiration, Pleural cavity tap, Pleural tap, Pleurocentesis, Puncture of Pleural Cavity for Aspiration, Thoracentesis, Thoracic paracentesis, Thoracocentesis |
| Spanish | pleurocentesis, puncion del espacio pleural para aspiracion, toracocentesis |
| Parent Concepts | Paracentesis (C0034115), Incision of pleura; thoracentesis; chest drainage (C0810121), Body part (C0229962), Other thorax operations (C0175584), Thoracic Surgical Procedures (C0524832), Non-thoracoscopic percutaneous pleural puncture procedure (C0405998), Procedure on pleural cavity (C1292962), Duplicate concept (C1274013) |
| Sources | AOD, CCS, HL7V2.5, ICD9CM, MTHCH, NCI, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |