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Depth of Pleural Effusion in Thoracentesis: Comparison of Lateral, Posterolateral and Posterior Approaches in the Supine Position.
Ko, Jeong Min; Kim, Jisoon; Park, Soo-An; Jin, Kwang Nam; Ahn, Myeong Im; Kim, Seok-Chan; Han, Dae Hee.
Afiliação
  • Ko JM; Department of Radiology, College of Medicine, St. Vincent's Hospital, Catholic University of Korea, Suwon, Korea.
  • Kim J; Department of Medicine, Advocate Christ Medical Center, University of Illinois, Chicago, USA.
  • Park SA; Department of Orthopedic Surgery, College of Medicine, Uijeongbu St. Mary's Hospital, Catholic University of Korea, Uijeongbu, Korea.
  • Jin KN; Department of Radiology, Boramae Medical Center, Seoul Metropolitan Government Seoul National University, Seoul, Korea.
  • Ahn MI; Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
  • Kim SC; Department of Internal Medicine, Division of Respiratory and Critical Care, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
  • Han DH; Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
Iran J Radiol ; 13(2): e20919, 2016 Apr.
Article em En | MEDLINE | ID: mdl-27679694
BACKGROUND: In patients who have difficulty sitting, thoracentesis is attempted in a supine position via lateral approach. Recently, a new table has been designed for supine thoracentesis. This table has gaps that allow access to the posterolateral and posterior hemithorax. OBJECTIVES: To compare important safety-related parameters between lateral, posterolateral, and posterior approaches in supine thoracentesis. MATERIALS AND METHODS: First, two cadavers were placed supine on a table featuring gaps allowing access to the posterolateral and posterior hemithorax. Water was administered with sonographic measurement of the depth of pleural effusion (DPE) at the mid-axillary and posterior axillary line. Second, CT images were analyzed in 25 consecutive patients (32 free-shifting, moderate-to-large effusions; mean, 668 (146 - 2020 mL). DPE, craniocaudal distance that effusion can be visualized (CCD), and presence of passive atelectasis at each of the lateral, posterolateral, and posterior routes was assessed. RESULTS: In each cadaver, DPE in the posterolateral route was greater than that in the lateral route (P = 0.002, P < 0.001). The amount of pleural fluid enough to spread DPE to higher than 1 cm at the posterior axillary line was less than half the amount at the mid-axillary line (500 mL vs. 1,100 mL; 800 mL vs. 1700 mL). CT showed that the DPEs and CCDs of posterolateral and posterior routes were greater than those of the lateral route (P < 0.001). In thirteen effusions (40.6%), DPE was greater than 1 cm in both posterolateral and posterior routes but less than 1 cm in the lateral route. Frequencies of passive atelectasis in posterolateral and posterior routes (81.3% and 90.6%) were higher (P < 0.001) than that in the lateral route (28.1%). CONCLUSION: Safety-related parameters of posterolateral and posterior approaches in supine thoracentesis are far better than that of the conventional lateral approach.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2016 Tipo de documento: Article