Self-Study Resources-Sundaralingam, Frequency, Risk factors and Management of Cx from Pleural Procedures, CHEST 2022

Sundaralingam, Frequency, Risk factors and Management of Cx from Pleural Procedures, CHEST 2022 - PDF

Pdf Summary

This extensive review analyzes complications associated with pleural procedures such as thoracocentesis, intercostal drains (ICDs), indwelling pleural catheters (IPCs), and local anesthetic thoracoscopy (LAT). Despite the prevalence of pleural interventions, consensus on complication rates and mitigation strategies is lacking. Iatrogenic pneumothorax is a common complication of thoracocentesis (3.3%), which significantly decreases with ultrasound guidance. Other complications include drain blockages and displacements, seen frequently with ICDs. IPCs, although beneficial for managing malignant pleural effusions (MPEs) and other conditions, carry risks of infections (5.8%) and mechanical issues like blockage, dislodgment, and fracture. LAT procedures, with a low overall mortality (0.1%), can cause complications such as bleeding (1.6%) and infections (4.5%).<br /><br />The review underscores the importance of procedural ultrasound to enhance safety and the need for standardized protocols to manage complications. The role of IPCs in reducing repeated invasive interventions is highlighted, although they require vigilant infection control and maintenance. The data collection for the review spanned from 2010 onwards, reflecting advancements in the use of thoracic ultrasound.<br /><br />Overall, while pleural procedure-related complications are relatively rare, their potential severity necessitates well-prepared plans for immediate intervention. This structured and comprehensive approach aims to ensure high-quality, safe patient care in the management of pleural diseases.

Meta Tag

Asset Type PDF

Curriculum Category Pulmonary Disease in Critical Care

Keywords

pleural procedures

thoracocentesis

intercostal drains

indwelling pleural catheters

local anesthetic thoracoscopy

iatrogenic pneumothorax

ultrasound guidance

complication rates

infection control

standardized protocols