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Updated: Jul 6, 2025

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
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Thoracentesis techniques: A literature review.

Asna Mohammed1, Uri Hochfeld1, Sung Hong2

  • 1Department of Internal Medicine, Hackensack University Medical Center, Hackensack, NJ, USA.

Medicine
|January 5, 2024
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Summary

This review of thoracentesis techniques found low complication rates across all methods. Suction-assisted drainage offers shorter procedure times and appears safe, with technique and patient factors influencing outcomes.

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Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Medical Procedures

Background:

  • Thoracentesis is a common procedure to drain pleural effusions.
  • Multiple techniques exist, including gravity, manual aspiration, and various suction methods.
  • The safety and complication rates of these different thoracentesis techniques require comprehensive review.

Approach:

  • A literature review was conducted, analyzing 6 studies encompassing 20,815 thoracenteses.
  • Complication rates were compared across gravity, manual aspiration, vacuum-bottle suction, and wall suction methods.
  • Data on procedure duration and specific complication types were extracted and analyzed.

Key Points:

  • Overall complication rate was 4.4%, with pneumothorax and re-expansion pulmonary edema (REPE) at 2.5%.
  • Manual aspiration had the lowest complication rate (1.2%), while gravity drainage had the highest (47.5%).
  • Suction-assisted methods (vacuum and wall) demonstrated shorter procedure times compared to gravity drainage.

Conclusions:

  • Thoracentesis by any technique has a low significant complication rate.
  • Suction-assisted drainage modalities appear safe and reduce procedure time.
  • Operator technique, patient factors, and fluid volume may influence complication rates more than the drainage method itself.