Re-expansion Pulmonary Edema (REPE) Following Thoracentesis: Is Large-Volume Thoracentesis Associated with Increased Incidence of REPE?

Autor: Scott S; Department of Interventional Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA. sscott4@kumc.edu., Morrison B; Department of Interventional Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA., Young K; Department of Biostatistics & Data Science, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA., Clark L; Department of Biostatistics & Data Science, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA., Li Y; Department of Biostatistics & Data Science, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA., Walter C; Department of Interventional Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA., Rohr A; Department of Interventional Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA., Alli A; Department of Interventional Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
Jazyk: angličtina
Zdroj: Cardiovascular and interventional radiology [Cardiovasc Intervent Radiol] 2024 Jul; Vol. 47 (7), pp. 912-917. Date of Electronic Publication: 2024 Jun 10.
DOI: 10.1007/s00270-024-03773-2
Abstrakt: Purpose: To determine the safety and efficacy associated with drainage volumes greater than 1,500 mL in a single, unilateral thoracentesis without pleural manometry measurements.
Materials and Methods: This retrospective, single-institution study included 872 patients (18 years and older) who underwent ultrasound-guided thoracentesis. Patient and procedures data were collected including demographics, number of and laterality of thoracenteses, volume and consistency of fluid removed, and whether clinical or radiologic evidence of re-expansion pulmonary edema (REPE) developed within 24 h of thoracentesis. Fisher's exact test was used to test the significance of the relationship between volume of fluid removed and evidence of REPE.
Results: A total of 1376 thoracenteses were performed among the patients included in the study. The mean volume of fluid removed among all procedures was 901.1 mL (SD = 641.7 mL), with 194 (14.1%) procedures involving the removal of ≥ 1,500 mL of fluid. In total, six (0.7%) patients developed signs of REPE following thoracentesis, five of which were a first-time thoracentesis. No statistically significant difference in incidence of REPE was observed between those with ≥ 1,500 mL of fluid removed compared to those with < 1,500 mL of fluid removed (p-value = 0.599).
Conclusions: Large-volume thoracentesis may safely improve patients' symptoms while preventing the need for repeat procedures.
(© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)
Databáze: MEDLINE