Thoracentesis contraindications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Shaik Aisha sultana, [3]


Contraindications

Absolute-

  • Thoracentesis has no absolute contraindications.

Relative-

  • Small fluid accumulations make thoracocentesis difficult and may increase the risk of pneumothorax. Ultrasound guidance helps in reducing the risk of pneumothorax or damage to lung tissue.
  • Positive pressure ventilation also increase the risk of pneumothorax.
  • Infection of the overlying skin.[1]
  • Uncorrected coagulopathy and thrombocytopenia predispose to bleeding complications, however, the risk of bleeding can be decreased by use of small and finer needles.
  • An uncooperative patient(esp.paediatric patients) can lead to damage to the underlying vascular structures and lung parenchyma. This can be avoided by generous use of sedation and analgesia.



References

  1. Fiser, Debra H.; Graham, James; Green, Jerril W.; Moss, Michele; Wankum, Patricia C.; Heulitt, Mark J.; Prince, Audra; Schexnayder, Stephen M.; Dick, Rhonda M. (2006). "Pediatric Vascular Access and Centeses": 151–182. doi:10.1016/B978-032301808-1.50018-3.

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