Original articleGeneral thoracicLarge-Volume Thoracentesis and the Risk of Reexpansion Pulmonary Edema
Section snippets
Patients and Methods
The study protocol was approved by the Internal Review Board of Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Informed consent was not required as the study entailed solely a review of medical records.
Results
In all, 185 patients (mean age, 68 years; SD, 15; 107 men [58%]) had at least 1 L pleural fluid removed at a single thoracentesis with concomitant pleural manometry. Thoracentesis was performed on the left lung in 78 patients (42%). The maximum volume of fluid removed was 6.55 L; mean (SD) volume was 1.67 L (0.76L; Fig 1).
Thoracentesis was most often terminated when no more fluid could be removed (Table 1). Diagnoses were made by pleural fluid analysis and patient history (Table 2), and have a
Comment
In the largest series of patients undergoing large-volume thoracentesis published to date, we found that RPE is in fact rare. Additionally, we believe that a radiographic diagnosis of RPE is clinically insignificant because dyspnea actually improved in our 4 patients with radiographic RPE. This belief is supported by other studies reporting that patients with radiographic RPE were asymptomatic and did not require specific therapy [8, 14].
The actual incidence of radiographic RPE may even be
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