Q: What is
the risk of Re-Expansion Pulmonary Edema (REPE) after
thoracentesis?
Answer: 0.18% per 1
ml of fluid removed
One study which span over 12 years and looked
into 9320 inpatient thoracenteses on 4618 patients found following complication
rates after the procedure
- 0.61% - iatrogenic pneumothoraces
- 0.01% - REPE and
- 0.18% - bleeding episodes.
Iatrogenic pneumothorax was significantly
associated with removal of >1500 mL fluid, unilateral procedures and more
than one needle pass through the skin (as expected).
For every 1 mL of fluid removed there was a
0.18% increased risk of REPE.
Interestingly, There were no significant
associations between bleeding and INR, PTT and platelet
counts.
Reference:
Mark J Ault, Bradley T Rosen, Jordan Scher, Joe Feinglass,
Jeffrey H Barsuk - Thoracentesis outcomes: a 12-year experience - Thorax
2015;70:127-132
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