Comparing Active Versus Passive Aspiration in Therapeutic Thoracentesis: Efficacy, Procedure Time, and Patient Safety

Comparing Active Versus Passive Aspiration in Therapeutic Thoracentesis: Efficacy, Procedure Time, and Patient Safety

This single-blind randomized controlled trial (RCT) aims to compare the efficacy and safety of active manual aspiration versus passive gravity drainage during therapeutic thoracentesis for large symptomatic pleural effusions. A total of 60 eligible patients will be randomized into two equal groups. The active aspiration group will undergo fluid removal using manual syringe suction, while the passive aspiration group will undergo drainage via gravity. The primary outcomes of the study are the total procedure time and the volume of pleural fluid aspirated. Secondary outcomes include patient-reported pain (measured on a Numeric Rating Scale), patient-reported dyspnea (measured by the mMRC scale), the incidence of procedure-related cough, and the reason for procedure termination. The goal of this study is to determine which technique offers a better balance of efficiency and patient comfort.

Inclusion Criteria:

• Patients of either gender.
• Aged above 18 years.
• With symptomatic large pleural effusion (either exudative or transudative).
• Requiring therapeutic pleurocentesis.
• Modified Medical Research Council (mMRC) dyspnea scale grade 3-4.

Exclusion Criteria:

• Uncorrected bleeding diathesis.
• Chest wall cellulitis at the intended site of puncture.
• Uncooperative patients.
• Loculated pleural effusion.
• Traumatic hemothorax.
• Empyema thoracis.
• Hydropneumothorax.
• Patients who refused to participate.