Safe and Effective Bedside Thoracentesis: A Review of the Evidence for Practicing Clinicians

Schildhouse, Richard J; Lai, Andrew; Mourad, Michelle; Chopra, Vineet

doi:10.12788/jhm.2716

Cited by 13 publications

(16 citation statements)

References 60 publications

(99 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The insertion of the chest drain identified the urgent need for the patient to undergo surgery. Pleural aspiration is a recognised gold standard in the investigation of pleural effusions; it is less invasive than a chest drain, performed easily at the bedside and relatively safer especially under ultrasound guidance 19. This could have been a useful diagnostic adjunct that may have resulted in an expedited diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Transthoracic Littre’s hernia presenting with faecopneumothorax following perforation of the Meckel’s diverticulum: a late complication of oesophagectomy

West¹,

Erskine

Hamdan

2017

BMJ Case Reports

View full text Add to dashboard Cite

A Littre's hernia is an unusual phenomenon where a Meckel's diverticulum protrudes through a potential abdominal opening. We wish to present a unique case of a 79-year-old man with respiratory distress following a fall from standing, initially managed as a haemothorax. After a chest drain was placed, bowel contents were drained from the pleural cavity and he was taken to theatre. He had a history of minimally invasive oesophagectomy for cancer and had subsequently developed a diaphragmatic hernia. A blind ending diverticulum with a perforation at its tip was found in the left oblique lung fissure that was subsequently confirmed histologically as a perforated Meckel's diverticulum. The patient had a prolonged stay on the intensive care unit with a left-sided empyema that was managed radiologically prior to discharge. Unfortunately 4 months postoperatively, he passed away from hospital-acquired pneumonia on a rehabilitation ward.

show abstract

Section: Discussionmentioning

confidence: 99%

Transthoracic Littre’s hernia presenting with faecopneumothorax following perforation of the Meckel’s diverticulum: a late complication of oesophagectomy

West¹,

Erskine

Hamdan

2017

BMJ Case Reports

View full text Add to dashboard Cite

show abstract

“…Hemorrhage is a rare complication of thoracentesis with an incidence rate from 0.12-2% and often due to laceration of an intercostal artery (ICA) or an associated branch (Figure 4). Cadaveric studies show increased tortuosity of the ICA within 6 cm of midline, in patients older than 60, and in more cephalad rib spaces (17). Physician-performed US was found to be 86% sensitive for identifying the ICA with median time to locate the vessel of 42 seconds for portable US and 18 seconds for high-end US (18).…”

Section: Thoracentesismentioning

confidence: 97%

Narrative review of vascular iatrogenic trauma and endovascular treatment

Smith¹,

Gage²,

Quencer³

2021

Ann Transl Med

View full text Add to dashboard Cite

Iatrogenic injury is unfortunately a leading cause of morbidity and mortality for patients worldwide. The etiology of iatrogenic injury is broad, and can be seen with both diagnostic and therapeutic interventions. While steps can be taken to reduce the occurrence of iatrogenic injury, it is often not completely avoidable. Once iatrogenic injury has occurred, prompt recognition and appropriate management can help reduce further harm. The objective of this narrative review it to help reader better understand the risk factors associated with, and treatment options for a broad range of potential iatrogenic injuries by presenting a series of iatrogenic injury cases. This review also discusses rates, risk factors, as well as imaging and clinical signs of iatrogenic injury with an emphasis on endovascular and minimally invasive treatments. While iatrogenic vascular injury once required surgical intervention, now minimally invasive endovascular treatment is a potential option for certain patients. Further research is needed to help identify patients that are at the highest risk for iatrogenic injury, allowing patients and providers to reconsider or avoid interventions where the risk of iatrogenic injury may outweigh the benefit. Further research is also needed to better define outcomes for patients with iatrogenic vascular injury treated with minimally invasive endovascular techniques verses conservative management or surgical intervention.

show abstract

“…Prophylactic substitution of blood products (platelet concentrates, fresh frozen plasma, or coagulation factors) should only be considered in patients with grave coagulation disorders (INR > 3, platelets < 25,000/mm³). [16] HH is characterized by a total cell count of polymorphonuclear cell (PMN) < 250/µL, a total protein concentration < 2.5 g/dL, an albumin gradient (serum -pleural fluid) > 1.1 g/dL, or an albumin quotient (pleural fluid/serum) < 0.6. Further optional parameters indicating HH are protein quotient < 0.5 (pleural fluid/ serum), a LDH gradient < 0.6 (serum -pleural fluid), and similar pH value as well as glucose concentration in serum and pleural fluid.…”

Section: Journal Of Translational Internal Medicine / Jul-sep 2020 / mentioning

confidence: 99%

Section: Hepatic Hydrothoraxmentioning

confidence: 99%

Pulmonary complications in patients with liver cirrhosis

Benz

Mohr

Tacke

et al. 2020

Journal of Translational Internal Medicine

View full text Add to dashboard Cite

Patients with advanced chronic liver diseases, particularly with decompensated liver cirrhosis, can develop specific pulmonary complications independently of any pre-existing lung disease. Especially when dyspnea occurs in combination with liver cirrhosis, patients should be evaluated for hepato-pulmonary syndrome (HPS), porto-pulmonary hypertension (PPHT), hepatic hydrothorax and spontaneous bacterial empyema, which represent the clinically most relevant pulmonary complications of liver cirrhosis. Importantly, the pathophysiology, clinical features, diagnosis and the corresponding therapeutic options differ between these entities, highlighting the role of specific diagnostics in patients with liver cirrhosis who present with dyspnea. Liver transplantation may offer a curative therapy, including selected cases of HPS and PPHT. In this review article, we summarize the pathogenesis, clinical features, diagnostic algorithms and treatment options of the 4 specific pulmonary complications in patients with liver cirrhosis.

show abstract

Safe and Effective Bedside Thoracentesis: A Review of the Evidence for Practicing Clinicians

Abstract: While the performance of thoracentesis is not without risk, clinicians can incorporate recent advances into practice to mitigate patient harm and improve effectiveness. Journal of Hospital Medicine 2017;12:266-276.

Cited by 13 publications

References 60 publications

Transthoracic Littre’s hernia presenting with faecopneumothorax following perforation of the Meckel’s diverticulum: a late complication of oesophagectomy

Transthoracic Littre’s hernia presenting with faecopneumothorax following perforation of the Meckel’s diverticulum: a late complication of oesophagectomy

Narrative review of vascular iatrogenic trauma and endovascular treatment

Pulmonary complications in patients with liver cirrhosis

Contact Info

Product

Resources

About