2. Overview
Thoracentesis is a procedure to remove fluid or air from around the lungs. A
needle is put through the chest wall into the pleural space. The pleural space is
the thin gap between the pleura of the lung and of the inner chest wall. The
pleura is a double layer of membranes that surrounds the lungs
3. Indications
Congestive heart failure (CHF), the most common cause
of pleural effusion
Viral, fungal, or bacterial infections
Cancer
Systemic lupus erythematosus (SLE) and other
autoimmune disease
Inflammation of the pancreas (pancreatitis)
A blood clot in the lung (pulmonary embolism)
An area of pus in the pleural space (empyema)
Liver failure
Tuberculosis (TB)
Pneumonia
4. Doctors are
also cautious
to perform
thoracentesis
on people
who:
can’t be safely repositioned
have bleeding disorders
are taking blood thinners
may have scarring from recent lung surgery
have other conditions where potential complications
outweigh benefits
5. Preparing for a
thoracentesis
tell your doctor if you:
are currently taking medications, including blood
thinners like aspirin, clopidogrel (Plavix), or warfarin
(Coumadin)
are allergic to any medications
have any bleeding problems
may be pregnant
have lung scarring from previous procedures
currently have any lung diseases like asthma
or emphysema
6. Before the
procedure
You may have imaging tests before the procedure. These
are done to find the location of the fluid to be removed.
You may have any of the below:
• Chest X-ray
• Chest fluoroscopy
• Ultrasound
• CT scan
7. Procedure
1. You may be asked to remove your clothes. If so, you will
be given a hospital gown to wear. You may be asked to
remove jewelry or other objects.
2. You may be given oxygen through a nasal tube or face
mask. Your heart rate, blood pressure, and breathing will
be watched during the procedure.
3. You will be in a sitting position in a hospital bed. Your
arms will be resting on an over-bed table. This position
helps to spread out the spaces between the ribs, where
the needle is inserted. If you are not able to sit, you may
lie on your side on the edge of the bed.
4. The skin where the needle will be put in will be cleaned
with an antiseptic solution.
5. A numbing medicine (local anesthetic) will be injected in
the area.
8. 6. When the area is numb, the healthcare provider will
put a needle between the ribs in your back. You may
feel some pressure where the needle goes in. Fluid
will slowly be withdrawn into the needle.
7. You will be asked to hold still, breathe out deeply, or
hold your breath at certain times during the procedure.
8. If there is a large amount of fluid, tubing may be
attached to the needle. This will let the fluid drain more.
The fluid will drain into a bottle or bag. In some cases, a
flexible tube (catheter) will be put in place of the needle
and the tubing will be attached for a day or two. You will
stay in the hospital until the catheter is removed.
9. When enough fluid has been removed, the needle will
be taken out. A bandage or dressing will be put on the
area.
10. Fluid samples may be sent to a lab.
11. You may have a chest X-ray taken right after the
procedure. This is to make sure your lungs are OK.
9. Risks
Air in the space between the lung covering (pleural
space) that causes the lung to collapse (pneumothorax)
Bleeding
Infection
Liver or spleen injury (rare)
Your risks may vary depending on your general health
and other factors.
10. After the
procedure
Your doctor will explain how to take care of the puncture
site. Make sure to contact your doctor if you begin to
have any signs of infection. Symptoms of infection
include:
trouble breathing
coughing up blood
fever or chills
pain when you take deep breaths
redness, pain, or bleeding around the needle site
