WhiskersWhat is Thoracentesis?
Thoracentesis is a medical procedure used to remove excess fluid or air from the space around the lungs. This is done by inserting a needle through the chest wall into the pleural space, which is the thin gap between the layers of the pleura. The pleura consists of two layers of membranes that surround the lungs, with a small amount of fluid in between to prevent them from rubbing together during breathing. When too much fluid builds up in this space, known as pleural effusion, it can make breathing difficult and cause pain, especially during physical activity.
Why Might Thoracentesis Be Necessary?
Thoracentesis is often performed to determine the cause of pleural effusion or to relieve its symptoms by removing the excess fluid. The fluid collected can then be analyzed in a laboratory to help diagnose underlying health conditions, such as:
- Congestive heart failure (CHF), a common cause of pleural effusion
- Infections caused by viruses, fungi, or bacteria
- Cancer
- Autoimmune diseases like systemic lupus erythematosus (SLE)
- Pancreatitis, which is inflammation of the pancreas
- Pulmonary embolism, or a blood clot in the lung
- Empyema, which is pus in the pleural space
- Liver failure
- Tuberculosis (TB)
- Pneumonia
- Adverse reactions to medications
Your healthcare provider may recommend Thoracentesis for other reasons based on your specific health situation.
What Are the Risks of Thoracentesis?
As with any medical procedure, Thoracentesis carries some risks. These may include:
- Air leakage into the pleural space, potentially causing the lung to collapse (pneumothorax)
- Bleeding
- Infection
- Rare injury to the liver or spleen
Your personal risk may vary depending on your overall health and other factors. It’s important to discuss any concerns with your healthcare provider before the procedure.
Preparing for Thoracentesis
Your healthcare provider will explain the procedure and may ask you to sign a consent form. Be sure to ask any questions you have and thoroughly review the form before signing. Inform your healthcare provider if you:
- Are pregnant or think you might be
- Have allergies to medications, latex, tape, or anesthetics
- Are taking any medications, including over-the-counter drugs, vitamins, herbs, or supplements
- Have a history of bleeding disorders
- Are on blood-thinning medications, aspirin, or other drugs that affect blood clotting
You may need to stop taking certain medications before the procedure. Plan to have someone drive you home afterward and follow any other instructions from your healthcare provider. You may also undergo imaging tests such as a chest X-ray, ultrasound, or CT scan before the procedure to locate the fluid that needs to be removed.
What Happens During Thoracentesis?
Thoracentesis can be performed on an outpatient basis, meaning you can go home the same day, or it may be done during a longer hospital stay. The procedure generally follows these steps:
- You may need to change into a hospital gown and remove any jewelry.
- Oxygen may be provided through a nasal tube or face mask, and your vital signs will be monitored.
- You will typically be seated in a hospital bed with your arms resting on a table, which helps to widen the spaces between your ribs.
- The skin where the needle will be inserted is cleaned with an antiseptic solution, and a local anesthetic is injected to numb the area.
- The healthcare provider inserts a needle between your ribs to withdraw the fluid, which may be drained into a bottle or bag if the amount is large.
- If necessary, a flexible catheter may be left in place for a day or two to allow further drainage.
- Once the fluid has been removed, the needle is taken out, and the site is bandaged.
- A sample of the fluid may be sent to a lab for analysis, and a chest X-ray might be taken afterward to ensure there are no complications.