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Related Concept Videos

Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Suctioning the Nasopharyngeal Airway01:29

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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
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Updated: Jun 20, 2025

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Gravity- vs Wall Suction-Driven Large-Volume Thoracentesis: A Randomized Controlled Study.

Samira Shojaee1, Jasleen Pannu2, Lonny Yarmus3

  • 1Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.

Chest
|July 19, 2024
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Summary
This summary is machine-generated.

Wall suction and gravity drainage during thoracentesis result in similar chest discomfort. This randomized trial found no significant differences in pain or breathlessness between the two large-volume fluid drainage methods.

Keywords:
complicationspleural effusionsuctionthoracentesis

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Area of Science:

  • Pulmonology
  • Interventional Procedures
  • Medical Devices

Background:

  • Previous research indicated no difference in chest discomfort between manual syringe aspiration and gravity drainage for thoracentesis.
  • The impact of wall suction's negative pressure gradient on chest pain post-thoracentesis remained uninvestigated.

Purpose of the Study:

  • To determine if wall suction drainage causes greater chest discomfort than gravity drainage in patients undergoing large-volume thoracentesis.

Main Methods:

  • A multicenter, single-blinded, randomized controlled trial compared wall suction versus gravity drainage for large-volume thoracentesis (≥ 500 mL).
  • Patients rated chest discomfort using a visual analog scale before, during, and after the procedure.
  • Primary outcome was postprocedural chest discomfort at 5 minutes; secondary outcomes included breathlessness, procedure time, fluid volume, and complications.

Main Results:

  • No significant difference in procedural chest discomfort was observed between wall suction and gravity drainage groups (P = .08).
  • Secondary outcomes, including postprocedural discomfort and dyspnea, also showed no significant differences.
  • Fluid volumes drained were similar, though the gravity drainage procedure took approximately 3 minutes longer. No differences in pneumothorax or reexpansion pulmonary edema rates were noted.

Conclusions:

  • Thoracentesis using either wall suction or gravity drainage yields comparable levels of procedural discomfort.
  • Both methods provide similar improvements in dyspnea for patients requiring large-volume fluid removal.