Frequency of Pneumothorax in Patients undergoing large Volume Thoracentesis
Keywords:Pleural fluid, thoracentesis, pneumothorax.
AbstractBACKGROUND: Pleural effusion is the accumulation of abnormal fluid in pleural cavity. Common causes are congestive heart failure, infection and malignancy. The removal of abnormal pleural fluid is known as thoracentesis. Complications of thoracentesis include pneumothorax, re-expansion pulmonary edema and bleeding. Risk factors include large amount of fluid tape, multiple attempts, underlying lung disease.OBJECTIVES: To determine the frequency of pneumothorax in patients undergoing large volume thoracocentesis.METHODOLOGY: This cross sectional prospective study was conducted at the Department of medicine, Mufti Mehmood teaching hospital D.I.Khan. Study duration was 6 months from 1st September 2019 to 28th February 2020.After informed consent, total of 241 patients of either gender, age between 20-70 years and diagnosed pleural effusion of more than 1000ml on ultrasound were included in the study. Patients with chronic lung disease and those with established pneumothorax were excluded. Demographic details like patient’s age and gender were recorded. All Patients undergone blind thoracocentesis by medical consultant followed by a chest radiograph in an erect position. The amount of fluid aspirated and presence or absence of pneumothorax was entered into the proforma.RESULTS: Out of 241 patients, 46.9% were female and 53.1% male. Mean age of the study population was 38.9 years with SD ± 11.27 and range of 20-69 years. 34 patients (14.1%) developed pneumothorax. Pneumothorax rate was found to be high in those with multiple attempts/needle pass.CONCLUSION: The risk of pneumothorax increases with increase in fluid volume aspirated. Risk versus benefit should be evaluated in attempting large fluid aspiration.