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Ep. 453 Thoracentesis Best Practices with Dr. Paul Lewis
BackTable Vascular & Interventional
Approach to Managing Complex Effusion in Thoracentesis
When encountering a complex effusion during thoracentesis with a small catheter, the strategy involves deep insertion using real-time ultrasound guidance, aspirating until fluid stops, backtracking to explore different pockets, and determining the purpose (diagnostic or therapeutic) to guide next steps. If sufficient diagnostic fluid is obtained, collaboration with the clinical team for further actions is crucial. Consideration may be given to placing a small chest tube and utilizing dornase or TPA for an extended course. The key lies in starting with the 'why,' employing real-time guidance for deep insertion, and adapting the approach based on aspirated fluid and clinical goals.
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