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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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lunes, 12 de agosto de 2019

Large pleural effusions

PulmCrit 
PulmCrit - August 12, 2019 - By Josh Farkas
"Summary The Bullet:
  • Large pleural effusions can generally be drained entirely (although the procedure should be stopped if the patient develops vague central chest discomfort).
  • Pleural manometry has not been shown to reduce discomfort or re-expansion pulmonary edema during large volume thoracentesis.
  • The rate of re-expansion pulmonary edema is low, even in large-volume thoracentesis (<1%). When it occurs, this can generally be treated with conservative measures (e.g. supplemental oxygen or noninvasive ventilation).
  • Using multiple small-volume thoracenteses to avoid large-volume thoracentesis is probably a misguided strategy. Multiple small-volume thoracenteses may cause an overall increase in the risk of procedural complications (due to increases in the risk of bleeding, infection, or lung laceration with multiple procedures)."