The importance of ultrasound guidance in thoracocentesis

Dr. Petru-Emil Muntean
Spitalul Județean de Urgență Argeș, Dispensarul de Pneumoftiziologie Pitești, România, Pneumologie


The ultrasound assures the pleural puncture “in sight”, and can be performed in two ways: by echo marking or by direct echo. There are several indications for the use of pleural ultrasound, grouped into two categories: diagnostic and therapeutic purpose. Ultrasonography is substantially better than physical examination in place selection for puncture. Ultrasound should be used in all cases when the appropriate equipment is available but also when the operator’s experience is tailor-made. Chest ultrasound is particularly useful as a diagnostic tool for the critically ill patient, as diagnostic information on pneumothorax, pulmonary consolidation, pleural effusion and pulmonary edema can be found. In addition, pleural ultrasonography demonstrated superior sensitivity compared to chest radiography in detecting the presence of pleural fluid and pneumothorax and in differentiating pleural fluid from pulmonary consolidation. Ultrasound used at the thoracic level can provide important clinical information and the value of it depends on the operator’s experience in obtaining and interpreting the image correctly. A complete and supervised training is necessary to ensure the correct interpretation of the sonographic results.

Keywords: thoracocentesis, ultrasound, treatment

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