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Thoracic Drainage
Brandt C. Wible, MD; Ashraf Thabet, MD
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KEY FACTS

  • Preprocedure

    • Procedure

      • Post Procedure

        • Outcomes

          TERMINOLOGY

          • Definitions

            • Pleural effusion: Fluid collection in pleural space
              • May be benign or malignant
              • May be loculated or nonloculated
            • Empyema: Infected pleural fluid collection
              • Usually secondary to pneumonia
              • May be posttraumatic
            • Thoracentesis: Percutaneous removal of fluid from pleural space
              • Diagnostic thoracentesis: Fluid removal for laboratory analysis
              • Therapeutic thoracentesis: Removal of large fluid volume for relief of respiratory difficulties
            • Chest tube placement: Percutaneous or surgical placement of drainage catheter into pleural space for removal of air or fluid; may/may not be left indwelling

          PREPROCEDURE

          • Indications

            • Contraindications

              • Preprocedure Imaging

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Procedure Steps

                      • Findings and Reporting

                        • Alternative Procedures/Therapies

                          POST PROCEDURE

                          • Things to Do

                            • Things to Avoid

                              OUTCOMES

                              • Problems

                                • Complications

                                  • Expected Outcomes

                                    Selected References

                                    1. Lui MM et al: Complications of indwelling pleural catheter use and their management. BMJ Open Respir Res. 3(1):e000123, 2016
                                    2. Merritt RE et al: Evidence-based suggestions for management of air leaks. Thorac Surg Clin. 20(3):435-48, 2010
                                    3. Josephson T et al: Amount drained at ultrasound-guided thoracentesis and risk of pneumothorax. Acta Radiol. 50(1):42-7, 2009
                                    4. Gervais DA et al: Adjunctive intrapleural tissue plasminogen activator administered via chest tubes placed with imaging guidance: effectiveness and risk for hemorrhage. Radiology. 246(3):956-63, 2008
                                    5. Feller-Kopman D et al: Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg. 84(5):1656-61, 2007
                                    6. Moulton JS: Image-guided management of complicated pleural fluid collections. Radiol Clin North Am. 38(2):345-74, 2000
                                    7. vanSonnenberg E et al: Percutaneous drainage of thoracic collections. J Thorac Imaging. 13(2):74-82, 1998
                                    8. Morrison MC et al: Sclerotherapy of malignant pleural effusion through sonographically placed small-bore catheters. AJR Am J Roentgenol. 158(1):41-3, 1992
                                    9. Silverman SG et al: Thoracic empyema: management with image-guided catheter drainage. Radiology. 169(1):5-9, 1988
                                    10. vanSonnenberg E et al: CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure. Radiology. 151(2):349-53, 1984
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Preprocedure

                                      • Procedure

                                        • Post Procedure

                                          • Outcomes

                                            TERMINOLOGY

                                            • Definitions

                                              • Pleural effusion: Fluid collection in pleural space
                                                • May be benign or malignant
                                                • May be loculated or nonloculated
                                              • Empyema: Infected pleural fluid collection
                                                • Usually secondary to pneumonia
                                                • May be posttraumatic
                                              • Thoracentesis: Percutaneous removal of fluid from pleural space
                                                • Diagnostic thoracentesis: Fluid removal for laboratory analysis
                                                • Therapeutic thoracentesis: Removal of large fluid volume for relief of respiratory difficulties
                                              • Chest tube placement: Percutaneous or surgical placement of drainage catheter into pleural space for removal of air or fluid; may/may not be left indwelling

                                            PREPROCEDURE

                                            • Indications

                                              • Contraindications

                                                • Preprocedure Imaging

                                                  • Getting Started

                                                    PROCEDURE

                                                    • Patient Position/Location

                                                      • Procedure Steps

                                                        • Findings and Reporting

                                                          • Alternative Procedures/Therapies

                                                            POST PROCEDURE

                                                            • Things to Do

                                                              • Things to Avoid

                                                                OUTCOMES

                                                                • Problems

                                                                  • Complications

                                                                    • Expected Outcomes

                                                                      Selected References

                                                                      1. Lui MM et al: Complications of indwelling pleural catheter use and their management. BMJ Open Respir Res. 3(1):e000123, 2016
                                                                      2. Merritt RE et al: Evidence-based suggestions for management of air leaks. Thorac Surg Clin. 20(3):435-48, 2010
                                                                      3. Josephson T et al: Amount drained at ultrasound-guided thoracentesis and risk of pneumothorax. Acta Radiol. 50(1):42-7, 2009
                                                                      4. Gervais DA et al: Adjunctive intrapleural tissue plasminogen activator administered via chest tubes placed with imaging guidance: effectiveness and risk for hemorrhage. Radiology. 246(3):956-63, 2008
                                                                      5. Feller-Kopman D et al: Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg. 84(5):1656-61, 2007
                                                                      6. Moulton JS: Image-guided management of complicated pleural fluid collections. Radiol Clin North Am. 38(2):345-74, 2000
                                                                      7. vanSonnenberg E et al: Percutaneous drainage of thoracic collections. J Thorac Imaging. 13(2):74-82, 1998
                                                                      8. Morrison MC et al: Sclerotherapy of malignant pleural effusion through sonographically placed small-bore catheters. AJR Am J Roentgenol. 158(1):41-3, 1992
                                                                      9. Silverman SG et al: Thoracic empyema: management with image-guided catheter drainage. Radiology. 169(1):5-9, 1988
                                                                      10. vanSonnenberg E et al: CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure. Radiology. 151(2):349-53, 1984