Safety and Tolerability of Vacuum Versus Manual Drainage During Thoracentesis: A Randomized Trial

M Senitko et al 

Journal of Bronchology and Interventional Pulmonology 2018 Nov 14. 


What is the key question?

  • Drainage of pleural effusion via intercostal catheter (ICC) is regularly used to diagnose and treat pleural effusion.
  • Economic factors make faster turn-around of these procedures more of an issue and the possibility of applying continuous suction to ICC to safely expedite drainage has not been tested.

What is the bottom line?

  • The authors compared drainage using vacuum bottles with kits using syringes. Pleural manometry was not performed.

Why read on?

  • Drainage of effusion using low pressure manually applied via a syringe was better tolerated, safer and less often terminated early due to complications than when pre-prepared vacuum bottles which may generate much greater negative pressure.
  • Use of vacuum drainage was faster by an average of three minutes over a volume of 1500mls compared to manually applied suction and was not considered clinically useful in this situation.