THIS STUDY HAS BEEN RETRACTED.
Kupfer et al looked retrospectively at 168 vented patients with transudative pleural effusions at Maimonides in Brooklyn. The half that got chest tubes (with an average of 1,200 mL drained) spent 3.8 days on the vent, vs 6.5 days for the group that got only thoracentesis, with no complications reported. That's interesting, but concluding and titling the paper "Chest Tube Drainage of Transudative Effusions Hastens Liberation from Mechanical Ventilation" without a randomized trial seems a bit, well, hasty. CHEST 2011;139:519-523.
A literature review by Medscape this month concluded there is no good evidence for or against draining pleural effusions in vented patients ... because, astonishingly, none of the 19 studies reviewed (n=1,124) reported mortality, duration of ventilation, or ICU LOS. There's an editorial this month and a recent meta-analysis on this thorny subject, both in Critical Care, as well as the results of a multicenter survey on local practices in the CHEST 12/2010 issue. And if that's not enough for you, Seminars in Respiratory & Critical Care Medicine's most recent issue is all about pleural disease.