Pulmonology Book

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Thoracentesis

Aka: Thoracentesis
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  1. See Also
    1. Pleural Effusion
    2. Pleural Effusion Causes
    3. Pleural Fluid Interpretation
    4. Chest Tube (Thoracostomy)
  2. Indications
    1. Effusion >10 mm thick
      1. Based on lateral decubitus XRay or Ultrasound
    2. Effusion not explained by other cause
      1. CHF not responding within 3 days to diuresis
      2. Asymmetric Pleural Effusions
      3. Fever
  3. Safety
    1. Ultrasound-guided Thoracentesis has less complications
      1. Jones (2003) Chest 123:418-23
  4. Contraindications
    1. Local cutaneous condition
    2. Severe Coagulopathy
      1. ProTime or Partial Thromboplastin Time twice normal
      2. Platelet Count <25,000
      3. Creatinine > 6 mg/dl
    3. Chest XRay with mediastinal shift toward effusion
      1. Suggests negative pleural pressure
      2. Suggests Bronchial obstruction
      3. Bronchoscopy recommended in these cases
  5. Complications
    1. Pneumothorax (11%)
      1. Requires Chest Tube in 2%
      2. Increased risk in COPD
      3. Decreased risk with experienced clinician
      4. Decreased risk with Ultrasound Guidance
    2. Cough
    3. Chest Pain
    4. Vasovagal Syncope
    5. Infection (2%)
    6. Hemothorax
  6. Precautions
    1. Limit fluid removal to 1500 cc
  7. Follow-up: Post-procedure Chest XRay Indications
    1. Post-procedure symptoms (Chest Pain, Dyspnea)
    2. Signs of Pneumothorax post-procedure
      1. Voice transmission absent superior to Thoracentesis
      2. Tactile fremitus absent superior to Thoracentesis
  8. Interpretation
    1. See Thoracentesis Interpretation
    2. See Pleural Effusion Causes

Thoracentesis (C0189477)

Definition (NCI) 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
SnomedCT 150556002, 91602002, 177818008
HL7 THORA
English Puncture of pleural cavity for aspiration, THORACENTESIS, thoracentesis, pleural tap, pleurocentesis, Pleural aspiration (procedure), Aspiration pleural cavity, Pleural cavity aspiration, Pleuracentesis, pleural aspiration, pleurocentesi, thoracocentesis, thoracentesys, chest aspiration, procedure thoracentesis, Pleurocentesis, Thoracentesis, Chest aspiration, Pleural aspiration, Pleural tap, Thoracic paracentesis, Thoracocentesis, Pleural cavity tap, Thoracentesis (procedure), Paracentesis of chest, Chest Aspiration, Pleural Cavity Tap, Pleural Tap, Puncture of Pleural Cavity for Aspiration, Thoracic Paracentesis
Italian Aspirazione della cavità pleurica, Toracentesi
Dutch pleuracentese, thoracocentese, pleuraholte aspiratie, aspiratie pleuraholte
French Pleuracentèse, Thoracentèse, Ponction de la cavité pleurale, Ponction pleurale
German Pleurazentese, Pleurahoehlenaspiration, Thorakozentese, Aspiration der Pleurahoehle
Portuguese Toracocentese, Pleurocentese, Aspiração da cavidade pleural
Spanish Pleuracentesis, Toracocentesis, Thoracic paracentesis, Pleural aspiration, Paracentesis of chest, pleurocentesis, punción del espacio pleural para aspiración, toracocentesis (procedimiento), toracocentesis, Aspiración de la cavidad pleural
Japanese 胸腔穿刺, 胸腔吸引, 胸膜穿刺, ｷｮｳﾏｸｾﾝｼ, ｷｮｳｸｳｾﾝｼ, ｷｮｳｸｳｷｭｳｲﾝ, ｷｮｺｸｳｾﾝｼ
Czech Punkce hrudníku, Punkce pleurálního výpotku, Aspirace z pleurální dutiny
Hungarian Pleuracentesis, Pleuralis üregi aspiratio, Pleuralis üreg aspiratio, Thoracentesis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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