The main purpose of diagnostic thoracentesis is uc following pleural fluid. Liquid obtained by thoracentesis , recommended for direct analysis Laboratories Rhee listed . To determine the pleural pH of the liquid sample should be maintained under anaerobic conditions and sent to the lab by placing the syringe in the pleural fluid ice. The results of the analyzes listed are discussed in Chapters 4 and 5.
Complications
Properly performed diagnostic thoracocentesis rarely causes serious complications. In some cases Diag -terrorist thoracentesis can provoke vasovagal reflex characterized bradycardia , decrease blow dimensional volume, cardiac output and decrease blood pressure. This reaction is blocked by intramuscular administration of 1 mg of atropine. An identical syndrome can be triggered by anxiety, emotions, such as a bad feeling, pain, or a type of blood. It is characterized by a sharp drop in peripheral vascular resistance without marked bradycardia. The patient has hypotension, pallor, oz nob, goose bumps and weakness. Atropine administration does not help with this syndrome. It is recommended to stop the manipulation and immediately place the patient in the Trendelenburg position .
In rare cases, diagnostic thoracocentesis may be complicated by pneumothorax. In most cases, this is due to indirect villa perform manipulation technique, whereby there is communication between the pleural cavity, with its negative nym pressure and the atmospheric air; air from the atmosphere enters the pleural cavity and causes pneumothorax. Slu tea needle may damage the lung, and air enters into stubble -sectoral cavity of the alveoli, which also causes pneumothorax As the frequency of pneumothorax during this manipulation ma la, we do not recommend necessarily after r1entgenografiyu di agnostic thoracentesis . We prefer to focus smiling at the level of tactile determined voice tremor above the level of pleural fluid. X-rays we about tormented, only if there is a decrease voice trembling Niya or there are complaints. Treatment of patients with iatrogenic pneumonia motoraksom discussed .
Another possible complication of thoracocentesis is infection of the pleural cavity. About 2% of all pleural GOVERNMENTAL infections caused by infection of the pleural cavity when performing thoracentesis . This emphasizes the need for sterility and thorough treatment of the skin before the start of the manipulation. Treatment of pleural dis infection is given in Chapter 9.
If the intercostal artery is damaged, hemothorax may develop. This complication is easily avoided if the puncture needle is held over the rib, as previously indicated. However, in elderly patients intercostal artery mo gut be tortuous, so they can haemothorax arose pull the even with proper respect M1etodiki . Treatment iatrogenic hemothorax discussed in Chapter 20. Other rare complications diagnostic thoracentesis is are damaged spleen or liver infitsirovanyae soft FIR tissue when bacterial infection and propagation cancer cells during needle insertion, as well as response to local anesthesia.