Division of Pulmonary & Critical Care Medicine

1. INR
   2. Less than 2.0 for Therapeutic Thoracentesis (includes the use of drainage catheter-6.0 Fr from the Thoracentesis Kit)
   3. Less than 2.5 for Diagnostic Thoracentesis (includes the use of NEEDLE ONLY, but no catheter). Average amount drained with needle is 20mL (depends on the procedure staff)

2. Platelet Count
   6. More than 50,000 for Therapeutic Thoracentesis (includes the use of drainage catheter-6.0 Fr from the Thoracentesis Kit)
   7. More than 25,000 for Diagnostic Thoracentesis (includes the use of NEEDLE ONLY, but no catheter). Average amount drained with needle is 20mL (depends on the procedure staff)

3. Medications
   1. Heparin IV. Should be stopped 4 hours before thoracentesis.
   2. Low Molecular Weight Heparin. Should be stopped for at least 36 hours.
   3. Should be stopped for 5 days.

EXCEPTIONS to these requirements could be made depending on the case (risks vs benefits). For exceptional cases, there should be a direct communication with the procedure staff.

References:

1. Transfusion 1991;31:164-171
2. Am J Roentgenol. 2011 Jul; 197(1):W164-8
3. Ann Am Thorac Soc 2013;10(4):336-341