Table 4 Thoracentesis complication rates in mechanically ventilated patients
Reference | Operator training | Ultrasound guidance | Systematic detection a | # Procedures in MV patients | Pneumothorax rate | Hemothorax rate | Additional findings |
|---|---|---|---|---|---|---|---|
Godwin 1990 | Student or resident (84%) or staff intensivist (16%) | None | Yes | 32 | 6.3% | n/a b | The pneumothoraces occurred after procedures performed by house staff No tension pneumothoraces |
Yu 1992 | Not specified | Puncture site marked | Yes | 14 | 7.1% | n/a | Â |
McCartney 1993 | Staff intensivist | Puncture site marked in some cases | Yes | 31 | 9.7% | 0% | No tension pneumothoraces |
Gervais 1997 | Resident or fellow | Puncture site marked | Yes | 90 | 6.7% | n/a | Only 1% of non-MV patients had pneumothorax (difference in rates was statistically significant) Only two of ten pneumothoraces required chest tubes (rest too small) |
Lichtenstein 1999 | Staff intensivist | Puncture site marked | Yes | 45 | 0% | 0% | Â |
Fartoukh 2002 | Not reported | None | Yes | Unknown | n/a | n/a | Five of six reported pneumothoraces occurred in patients on MV |
De Waele 2003 | Staff intensivist | None | Yes | 33 | 15% | 0% | nine pneumothoraces in all patients hemothorax |
Singh 2003 | Not specified | None | Yes | 12 | 0% | 0% | Â |
Ahmed 2004 | Not reported | Real-time guidance | No | 31 | 0.0% | 0% | Â |
Mayo 2004 | Resident or fellow | Puncture site marked | Yes | 232 | 1.3% | 0% | No tension pneumothoraces |
Tu 2004 | Not specified | Real-time guidance | Yes | Unknown | 0% | n/a | No pneumothoraces in all patients two hemothoraces in all patients (Data included in Tu 2006) |
Roch 2005 | Not specified | None | Yes | 44 | 0% | 4.5% | Â |
Vignon 2005 | Not specified | Puncture site marked | Yes | 17 | 0% | 0% | Pneumothorax data available only on 17 MV patients (unknown how many other procedures were done on patients on MV) |
Balik 2006 | Staff intensivist | Puncture site marked | Yes | 92 | 0.0% | 0% | Â |
Tu 2006 | Not specified | Real-time guidance | Yes | 184 | 0% | 1.1% | Â |
Liang 2009 | Staff intensivist | Puncture site marked | Yes | 108 | 0% | n/a | one hemothorax in all patients No pneumothoraces in non-MV patients three subcutaneous hematomas four infections related to drainage seven kinked catheters |