To the Editor.—It is important that the findings of Grogan et al1 be interpreted and acted on cautiously, which the authors have done. A prospective study finding an overall complication rate of 50%, which includes a 20% rate of pneumothoraces in patients who undergo thoracentesis by the needleonly method (23% in diagnostic thoracentesis) and a 39% rate of pneumothoraces in those undergoing thoracentesis by the needle-catheter method, but a 0% rate of pneumothorax in patients undergoing sonography-guided thoracentesis, could result in the recommendation that the sonography-guided method become the procedure of choice for the majority of patients undergoing thoracentesis. This study, however, relies on statistics based on procedures performed by house officers, many of whom were probably very inexperienced (house officers were required to attend extensive didactic sessions, but to have performed only one supervised thoracentesis "to be certified as competent").
The rate of pneumothorax and other complications
SCHIFFMAN PL. Complications of Thoracentesis. Arch Intern Med. 1990;150(12):2598-2600. doi:10.1001/archinte.1990.00390230134029