Disorders of the Pleura |

How Much Negative Pressure Is Generated During Manual Thoracentesis? FREE TO VIEW

Rebecca Cloyes, MS; Muralidhar Kondapaneni; Soud Sedique; Shaheen Islam
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Ohio State University, Columbus, OH

Chest. 2014;146(4_MeetingAbstracts):446A. doi:10.1378/chest.1993719
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SESSION TITLE: Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Normal pleural pressure is -9 to -11cm H2O. During manual thoracentesis with a syringe, negative pressure is created to drain the pleural fluid. There is no report on how much negative pressure is generated during the process. This pilot study was done to measure the pressure created during a simulated thoracentesis.

METHODS: We used a digital manometer (Compass, Mirador Biomedical Inc. Seattle, WA) to measure the pressure variation. A 60cc syringe was connected through an in-line digital manometer to a 1L saline bag. Readings were obtained with both the saline bag and manometer at the same level during aspiration. Twenty volunteers were observed during the simulated thoracentesis. They were instructed to first drain as if they are doing a thoracentesis blinded to the pressure readings and then to remove 60cc while monitoring the manometer to keep the pressure below -20cm H2O. The duration and pressure were recorded.

RESULTS: The average pressure generated during the blind thoracentesis was -236.19cm H2O ± 61.56. The average time taken to remove 60ml of fluid using the syringe while blinded was 20.95 seconds ± 4.34. The average time taken to remove 60ml of fluid while maintaining -20cm H2O pressure is 127.14 seconds ± 42.75.

CONCLUSIONS: The average pressure generated during manual thoracentesis with a 60cc syringe is 236.19 which is much more negative than normal pleural pressure.

CLINICAL IMPLICATIONS: By generating extremely negative pleural pressure during manual thoracentesis we risk causing pneumothorax ex-vacuo. Monitoring manometer readings during thoracentsis may help reduce those complicaitons.

DISCLOSURE: The following authors have nothing to disclose: Rebecca Cloyes, Muralidhar Kondapaneni, Soud Sedique, Shaheen Islam

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