Thoracentesis and anticoagulation

Patients who are critically ill and hospitalized often require invasive procedures as a part of their medical care. Each procedure carries a unique set of risks and associated complications, but common to all of them is the risk of hemorrhage. Central venous catheterization, arterial catheterization, paracentesis, thoracentesis, tube thoracostomy, and lumbar puncture constitute a majority of the procedures performed in patients who are hospitalized. In this article, the authors will discuss the risk factors for bleeding complications from each of these procedures and methods to minimize risk...

PURPOSE OF REVIEW: Thoracentesis is a commonly performed procedure throughout the world. Convention dictates that patients should have laboratory values such as international normalized ratio (INR) and platelets corrected or medications that affect bleeding withheld prior to performing this procedure. By transfusing blood products or withholding medications, patients are exposed to risks that are different than but equally if not more significant than the risk of hemothorax from thoracentesis...