Friday, April 10, 2015

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. 


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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