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Pneumothorax after thoracentesis in chronic obstructive pulmonary disease
R D Brandstetter1, M Karetzky, R Rastogi
1New Rochelle Hospital Medical Center, New Rochelle, N.Y.
Heart & Lung : the Journal of Critical Care
|January 1, 1994
Summary
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of pneumothorax after thoracentesis. This procedure may be safer when guided by sonography due to lung changes in COPD.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Imaging
Background:
- Thoracentesis is a common procedure for pleural effusion management.
- Chronic obstructive pulmonary disease (COPD) involves significant changes in lung parenchyma and mechanics.
- The risk of pneumothorax following thoracentesis in COPD patients is not well-established.
Purpose of the Study:
- To investigate the incidence of pneumothorax after thoracentesis in patients with and without COPD.
- To identify potential risk factors or procedural elements influencing pneumothorax development.
Main Methods:
- Prospective study conducted at a community hospital.
- 106 patients undergoing thoracentesis, with 36 diagnosed with COPD.
- Pneumothorax identified via chest roentgenogram post-procedure; follow-up within 2 hours.
Main Results:
- COPD patients exhibited a significantly higher pneumothorax rate (41.7%) compared to non-COPD patients (18.5%; p=0.005).
- Procedure performance (resident vs. specialist), indication (diagnostic vs. therapeutic), and fluid volume removed did not affect pneumothorax frequency.
Conclusions:
- Pneumothorax is a frequent complication of thoracentesis in COPD patients.
- Altered lung architecture and mechanics in COPD may contribute to increased risk.
- Sonography-guided thoracentesis may be a safer alternative for this patient group.