Safety of ultrasound-guided thoracentesis in patients receiving mechanical ventilation.

OBJECTIVE To determine the safety of ultrasound-guided thoracentesis (UST) performed by critical care physicians on patients receiving mechanical ventilation. DESIGN Prospective and observational. SETTING ICUs in a teaching hospital. PATIENTS Two hundred eleven serial patients receiving mechanical ventilation with pleural effusion requiring diagnostic or therapeutic thoracentesis. INTERVENTIONS Two hundred thirty-two separate USTs were performed by critical care physicians without radiology support. Anteroposterior chest radiographs were reviewed for possible postprocedure pneumothorax. RESULTS Pneumothorax occurred in 3 of 232 USTs (1.3%). The procedure was well tolerated in this critically ill population. CONCLUSIONS UST performed in patients receiving mechanical ventilation without radiology support results in an acceptable rate of pneumothorax.