Safely performed if there is greater than 1 cm of fluid on the lateral decubitus film chest-x-ray.
Common practice is to obtain a CXR after the procedure but in the absence of suspicion or clinical indication of a complication is it not a warranted in the vast majority of cases.
An estimated 173,000 are performed annually according to a 1998 National Center for Health Statistics study (Owings MF).
Pneumothorax rates ranging from 0% to 19% (Leichtenstein D, Grogan DR).
Iatrogenic pneumothorax increases morbidity, mortality and length of hospital stay.
Chest tube insertion may be required up to 50% of cases with iatrogenic pneumothorax, with a median duration of chest tube placement of 4 days (Despars JA, Sassoon CS).
In a review and neck analysis of 6605 thoracenteses in 24 studies be overall pneumothorax rate was 6% and 34.1% required chest tube placement (Gordon CE).
Use of ultrasound significantly lowers the risk of pneumothorax and lower rates are observed with more experienced operators(Gordon CE).
Pneumothorax is much more likely to follow therapeutic thoracenteses, the need for 2 or more needle insertions, and when associated with mechanical ventilation(Gordon CE).