Feasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients.
Intensive Care Med
; 25(9): 955-8, 1999 Sep.
Article
em En
| MEDLINE
| ID: mdl-10501751
ABSTRACT
OBJECTIVE:
Thoracentesis in a ventilated patient is rarely performed because of the risk of pneumothorax. We have evaluated the safety of this procedure when aided by ultrasound.DESIGN:
Prospective study.SETTING:
Medical intensive care unit, university-affiliated hospital. PATIENTS 45 procedures were performed in 40 consecutive patients with ultrasound signs of pleural effusion, all mechanically ventilated.INTERVENTIONS:
Pleural effusion was defined on ultrasound as a collection of fluid between parietal and visceral pleura leading to variations in interpleural distance during breathing. When the interpleural distance was >/= 15 mm and visible over three intercostal spaces, a needle (16 or 21 G) was inserted after ultrasound localization in a patient in either dorsal or lateral decubitus.RESULTS:
No complication occurred in the 45 thoracenteses. Fluid was obtained in 44 of 45 procedures, thus confirming the diagnosis of pleural effusion. The procedure was immediate (less than 10 s) in 40 of 45 cases. It was easy (i. e., keeping the patient supine) in 22 of 45 procedures. In 44 cases where fluid was obtained, only 27 bedside radiographs revealed signs of effusion, whereas 17 showed absence of a visible effusion. Ultrasound thus appeared more efficient than bedside X-ray in detecting pleural effusion.CONCLUSIONS:
If basic rules are followed, ultrasound localization makes thoracentesis a safe, easy and simple procedure in patients on mechanical ventilation.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Segurança
/
Ultrassonografia de Intervenção
/
Paracentese
/
Procedimentos Cirúrgicos Torácicos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
França