Novel Supine Thoracentesis Bed Enabling Thoracentesis Via The Posterior Axillary Line

Abstract

This study describes on supine thoracentesis bed (STB), which helps thoracentesis of supine patient by enabling unlimited access to the posterolateral surface of a hemithorax. Records of 15 patients who had received US-guided supine thoracentesis on STB were reviewed. We investigated the lateral or posterolateral approaches selected by the operators. We reviewed pre-procedural CT scans (obtained within 1 day) to examine if the approach of the operators could be justified in terms of depth of effusion and overlying chest wall thickness. The most common rationale for the use of the supine position was back or leg pain in 6 patients and hemi-or quadriplegia in 4. The operators chose the posterolateral approach in all 15 patients. On 6 concurrent CT scans, the mean depth of effusion was significantly (p < 0.004) greater in the posterolateral approach (3.0 ± 2.2 vs. 1.5 ± 1.9 cm). There was no significant difference in the thickness of the chest wall between the two approaches (1.6 ± 0.3 vs. 1.8 ± 1.0 cm, p = 0.61). By using STB, supine thoracentesis can be done via the posterolateral approach, which was associated with greater depth of effusion in our study, and may be superior to the conventional lateral approach.