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

Sheikh Zayed Federal Postgraduate Medical Institute

Status: Completed

Conditions: Pleural Effusion

Treatments: Procedure: Active Manual Syringe Aspiration; Procedure: Passive Gravity Drainage

Study type: Interventional

Funder types: Other

Identifiers

NCT07184736

No funding

TMahmud

Details and patient eligibility

About

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.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

60 participants in 2 patient groups

Active Aspiration

Experimental group

Description:

For the Active Aspiration Group (n=30), fluid was actively aspirated using a syringe and expelled into a collection bag via a 3-way stopcock.

Treatment:

Procedure: Active Manual Syringe Aspiration

Passive Aspiration

Experimental group

Description:

In the passive Aspiration Group (n=30), after initial aspiration to confirm needle placement, the syringe was removed, and fluid was allowed to drain passively via gravity into the collection bag.

Treatment:

Procedure: Passive Gravity Drainage