Thoracentesis-Related Complications: A Comparison Between Vacuum-Assisted and Manual Aspiration Methods

Thoracentesis is a commonly performed bedside procedure for diagnostic evaluation or symptomatic relief of pleural effusions. Although generally considered low risk, prior studies comparing complication rates between aspiration methods, particularly manual and vacuum-assisted aspiration, have reported mixed results. We therefore compared complication rates between these two methods among patients undergoing ultrasound-guided thoracentesis by a hospitalist-led procedure service at a community teaching hospital. Thoracentesis-related complications, including pneumothorax, hemothorax, procedure site bleeding, and re-expansion pulmonary edema were assessed. A total of 96 patients underwent manual aspiration and 97 underwent vacuum-assisted aspiration. Patient demographics and comorbidities were similar between groups with no statistically significant differences. Overall complication rates were low, with no statistically significant difference between manual and vacuum-assisted aspiration (1.0% vs 2.1%, P=1.00). These findings provide additional comparative safety data for bedside thoracentesis. The retrospective design and low event rates may have limited detection of small but clinically meaningful differences, which larger, prospective studies could better define.