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