Thoracentesis

Thoracentesis is used diagnostically to establish the cause of a pleural effusion. It can also be performed to drain large effusions that lead to respiratory compromise. Contraindications Limited data exist regarding the safety of thoracentesis in patients with coagulation abnormalities. The procedure is probably safe in patients with mild or moderate elevations of the prothrombin time or partial-thromboplastin time. The decision to use fresh-frozen plasma or platelet concentrates in patients with clinically significant coagulopathy or thrombocytopenia must be made on an individual basis. The procedure should be used with care in patients who are receiving mechanical ventilation, since positive-pressure . . . .