SHM Converge Scientific Abstract ePoster Gallery-Should We Use Pleural Manometry Routinely During Thoracentesis?

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This retrospective single-center study examined whether routine pleural manometry (PM) during thoracentesis improves drainage volume and outcomes in hospitalized adults. The motivation was that thoracentesis can rarely cause re-expansion pulmonary edema (RPE), so clinicians often limit drainage to 1.5 L, while PM may allow safer removal of larger volumes by monitoring pleural pressure.<br /><br />The study compared thoracenteses performed with versus without PM from July 2021 to July 2023. The primary outcome was the volume of pleural fluid removed. Secondary outcomes included serious complications (iatrogenic pneumothorax requiring chest tube and clinical RPE), post-procedure length of stay (PP-LOS), and 30-day readmission for repeat thoracentesis.<br /><br />Results showed that PM was associated with greater fluid removal: 1220 mL versus 800 mL without PM. PM was also associated with a shorter PP-LOS: 79 versus 135 hours. In adjusted analyses, PM remained associated with both larger drainage volume and shorter PP-LOS. However, there was no significant difference in serious complications: there was one pneumothorax in each group and one RPE case in the non-PM group. Thirty-day readmission rates for repeat thoracentesis were also similar between groups (13% with PM vs 9% without PM).<br /><br />Overall, the study suggests that routine use of pleural manometry during thoracentesis may enable removal of larger fluid volumes and shorten hospital stay without increasing major complications or readmissions. The authors note, however, that the study was observational, could not control for all confounding factors, and was underpowered to detect differences in safety outcomes.

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Jonathan T. Sebolt

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Author List Alexander Harris, Anna Conlon, Blake Haller, Brett Curtis, Brice Taylor, David Paje, Gabriella Rubick, Jacklyn N. Thibert, Jonathan T. Sebolt, Katie Liu, Maxwell Krasity, Michael Adams, Sachita Shrestha, Shuo Tian, Stephanie Taylor, Trevor Denton

Category Research

Concept Manometry

Concept Thoracentesis

Concept Pleural Fluid Volume

Concept Pleural Pressure

Concept Iatrogenic Pneumothorax

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Jonathan T. Sebolt

Track Outcomes Research

Keywords

pleural manometry

thoracentesis

pleural effusion

re-expansion pulmonary edema

drainage volume

hospitalized adults

post-procedure length of stay

pneumothorax

readmission

retrospective study

Manometry

Thoracentesis

Pleural Fluid Volume

Pleural Pressure

Iatrogenic Pneumothorax