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Table 4 Thoracentesis complication rates in mechanically ventilated patients

From: Utility and safety of draining pleural effusions in mechanically ventilated patients: a systematic review and meta-analysis

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  
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%  
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%  
Ahmed 2004 Not reported Real-time guidance No 31 0.0% 0%  
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%  
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%  
Tu 2006 Not specified Real-time guidance Yes 184 0% 1.1%  
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
  1. aProtocol included pre-specified detection of complications of procedure including either chest radiography or chest ultrasound.
  2. bn/a, not available; that is, not reported in the paper or, if reported, the rate is not specific to patients on mechanical ventilation.
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