Safety of ultrasound-guided thoracentesis in patients with abnormal preprocedural coagulation parameters
| Autor: | Rickey E. Carter, Alexander Lekah, Jennifer S. McDonald, Maitray D. Patel, Jeffrey T. Rabatin, Rebecca M. Hibbert, Thomas D. Atwell |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Blood transfusion Adolescent medicine.medical_treatment Thoracentesis Hemorrhage Critical Care and Intensive Care Medicine medicine Humans Paracentesis In patient Blood Transfusion International Normalized Ratio Ultrasonography Interventional Aged Retrospective Studies Aged 80 and over business.industry Platelet Count Incidence (epidemiology) Retrospective cohort study Common Terminology Criteria for Adverse Events Blood Coagulation Disorders Middle Aged Surgery Coagulation Female Fresh frozen plasma Patient Safety Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 144(2) |
| ISSN: | 1931-3543 |
| Popis: | Background Despite a low incidence of hemorrhagic complications following thoracentesis, correction or attempted correction of abnormal preprocedural coagulation parameters is still commonly performed. We aimed to assess hemorrhagic complications following ultrasound-guided thoracentesis in patients with abnormal preprocedural coagulation parameters. Methods We analyzed 1,009 ultrasound-guided thoracenteses performed between January 2005 and September 2011 on patients with international normalized ratio (INR) > 1.6, serum platelet values 9 /L, or both. Procedures were divided into two groups: those in whom abnormal preprocedural coagulation parameters were not corrected before the thoracentesis (group 1) and a second group in which patients received a transfusion of platelets or fresh frozen plasma prior to thoracentesis (group 2). All procedures were evaluated for hemorrhagic complications as defined by the National Institutes of Health Common Terminology Criteria for Adverse Events. Results A total of 1,009 ultrasound-guided thoracenteses were included in our study, consisting of 706 procedures in 538 patients in group 1 and 303 procedures in 235 patients in group 2. There were four hemorrhagic complications out of 1,009 procedures (0.40%; 95% CI, 0.15%-1.02%): zero in group 1 (0 of 706 or 0.0%; 95% CI, 0%-0.68%) and four in group 2 (four of 303 or 1.32%; 95% CI, 0.51%-3.36%). Conclusions Hemorrhagic complications are infrequent after ultrasound-guided thoracentesis, and attempting to correct an abnormal INR or platelet level before the procedure is unlikely to confer any benefit. We consider the procedure safe in patients with abnormal preprocedural parameters when performed by expert personnel. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|