Chest
Original ResearchPulmonary ProceduresSafety of Ultrasound-Guided Thoracentesis in Patients With Abnormal Preprocedural Coagulation Parameters
Section snippets
Materials and Methods
Approval for this retrospective study was obtained from our institutional review board (Mayo Clinic Institutional Review Board #11-006350). The study was compliant with the Health Insurance Portability and Accountability Act.
Results
A total of 1,059 ultrasound-guided thoracenteses were initially identified as being eligible for review. Fifty procedures (5%) were excluded, as patients had not authorized their records for use in research. The resulting sample consisted of 773 patients having undergone 1,009 procedures. Table 1 presents the demographic, preprocedural laboratory results and procedural summary for the 773 patients at their first procedure. A majority of the sample was men (53%), and the mean age was 67 (±15)
Discussion
The precise incidence of hemorrhagic complications following ultrasound-guided thoracentesis by expert operators in patients with abnormal preprocedural coagulation parameters remains unclear. Moreover, the benefit of preprocedural transfusion of platelets or FFP prior to these procedures remains controversial. We present, to our knowledge, the largest series of ultrasound-guided thoracenteses specifically evaluating a population with abnormal preprocedural coagulation parameters. We show that
Conclusions
Hemorrhagic complications are infrequent after ultrasound-guided thoracentesis, and preprocedure transfusion to correct an abnormal INR or platelet level before the procedure is unlikely to confer any benefit. We consider the procedure to have low risk of hemorrhagic complications in patients with abnormal preprocedural coagulation parameters when performed by experienced personnel under direct ultrasound guidance.
Acknowledgments
Author contributions: Dr Hibbert is the guarantor of this article.
Dr Hibbert: contributed to study conception and design; acquisition, analysis, and interpretation of data; drafting of the manuscript; and revising, reading, and approving the final version of the manuscript.
Dr Atwell: contributed to study conception and design; oversight and conduct of the study; analysis and interpretation of data; and revising, reading, and approving the final version of the manuscript.
Dr Lekah: contributed to
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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