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Pneumothorax After Thoracentesis

Andrew J. Swinburne, MD; Karen Bixby, RN; Anthony J. Fedullo, MD; David Lee, MD; Gary W. Wahl, MD
Arch Intern Med. 1991;151(10):2095. doi:10.1001/archinte.1991.00400100147025.
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To the Editor. —  The study by Grogan and coworkers1 describing complications of thoracentesis prompted us to review our experience, because the 19% incidence of pneumothorax reported by the authors seemed high. During 1989,105 thoracenteses were performed on patients treated in our medical service. Six of these (5.7%) were complicated by pneumothorax. Other authors (Table) have described pneumothorax rates varying from 10.7% to 13.4%.2-5We speculate that many mechanisms may explain pneumothoraces that occur after thoracentesis. The lung may be punctured at the time of needle entry. Small amounts of air may be drawn into the chest while the aspiration system is being manipulated, or air may be drawn along the needle track if high negative intrapleural pressures develop. The lung may also be punctured if fluid is withdrawn and the lung surface is brought into contact with the drainage needle or catheter.Grogan et al1 suggested

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