Managing Malignant Pleural Effusions: Thoracentesis

Dr. Jed Gorden describes the details of how a thoracentesis is performed in order to clarify the diagnosis and treat symptoms of a malignant pleural effusion (MPE).

[@konstantinuswilfridusbeso6534]

Hello Doctor Jed Gorden,i hope you still remember me..i am Willy beso,once was your guide on your traveling to Bajawa in 1989 ,long time ago..warm regards to you and family.

[@vvmac71]

Thank you for sharing this!

[@CancergraceOrg]

So glad it was helpful.

[@chrissynz6974]

Hi thankyou for this, i have stage 4 breast cancer and my right lung has bout 3/4 surrounded by malignant fluid and am being assesed by the hospital respiratory dept, if they decide it will be done this week apparantly. Just a bit scared of the pain and imagine i will be anxious. Im told i have to be awake for this, can they sedate me a bit to help with that?

[@nerbnerb7398]

how are you?

[@liveandletlive185]

Cough after certain amount of fluid aspiration is not ok🙏 it's a sign to stop.

[@CancergraceOrg]

Hi live and let live. I'm not sure what certain amount you're suggesting a thoracentesis should be stopped. For others reading this I'm sure you'd agree that it's important to know that coughing is considered normal during aspiration, as the lung reexpands. However, uncontrolled coughing may become a reason to stop.
There have been several clinical studies published in just the last few years about pleural pressure and cough during the procedure. In this video, Dr. Gorden warns that a cough is expected as the lung re-expands.
The most recent studies suggest that the rise in pressure caused by coughing shouldn't always be considered an adverse event.
Here are a couple of abstracts on the subject, pubmed.ncbi.nlm.nih.gov/35798822/
pubmed.ncbi.nlm.nih.gov/25367064/
With any type of invasive procedure, there is a balance to be made between when to advance and when to pull back. That's why it's best to have this type of procedure done by a specialist who performs them on a regular basis.