Thoracentesis

(Pleural Fluid Aspiration; Pleural Tap)

Definition

A pleural effusion is a build-up of fluid in the space between the lungs and the chest wall. This space is called the pleural space. Thoracentesis is a procedure to remove fluid from this area. There are two types of thoracentesis:
  • Therapeutic thoracentesis—to relieve the symptoms of fluid accumulation
  • Diagnostic thoracentesis—to test for the cause of the fluid build-up

Reasons for Procedure

There is always a small amount of fluid in the pleural space. The fluid helps to lubricate the area. When too much fluid builds up in this space, it can make it difficult to breathe.Your doctor may want to test some of the fluid after removing it. The build-up of fluid can be a symptom of diseases or disorders, such as:
  • Heart failure
  • Lung infections
  • Kidney disease
  • Pulmonary embolism—a clot that travels to the lung
  • Cancer
  • Collagen vascular disease like sarcoidosis or lupus
  • Liver disease
  • Pancreatitis
  • Asbestos exposure

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Collapsed lung
  • Fluid building up again
  • Bleeding
  • Infection
  • Damage to the lung, liver or spleen
Factors that may increase the risk of complications include:Factors that may increase the risk of complications include:
  • A history of lung surgery
  • A long-term, irreversible lung disease, such as emphysema or poorly controlled asthma
  • Smoking
  • Anything affecting normal blood clotting

What to Expect

Prior to Procedure

Your doctor may order:
  • A complete physical exam
  • Blood tests
  • X-ray
  • CT scan
  • Ultrasound

Anesthesia

A local anesthetic will be used. It will numb the area where the needle will be inserted.

Description of the Procedure

You may be asked to sit upright on the edge of a bed or chair. Your arms will be resting on a nearby table. If your procedure involves a CT scan, you may be asked to lie on a table. Try to avoid coughing, breathing deeply, or moving during the procedure.A small patch of skin on your back, chest, or under your armpit will be sterilized. Anesthesia will be applied to this patch. It will help numb the area.The doctor may use ultrasound or CT scan images to guide the needle and monitor the fluid. A needle or thin plastic catheter will be inserted between your ribs. The needle or catheter is then passed into the pleural space. Some or all of the fluid will be drawn into the syringe.
Placement of Thoracentesis Needle
Placement of Thoracentesis Needle
© 2011 Nucleus Medical Media, Inc.

How Long Will It Take?

About 15 minutes

Will It Hurt?

You may feel slight pain or a stinging when the needle is first inserted. As the fluid is being extracted, you may feel a sense of pulling. Tell your healthcare team if you feel extreme pain, any shortness of breath, or faint.

Post-procedure Care

At the Care CenterIf the thoracentesis is being done for diagnostic reasons, the fluid will be sent to a lab for testing. Often, another chest x-ray will be done to ensure that the fluid has been removed and that there is no sign of a collapsed lung.The doctor may begin treatment for the cause of the fluid build-up.At Home Keep the area of skin where the needle was inserted clean and dry to avoid infection. You may have your activity restricted during your recovery.If a diagnostic thoracentesis was done, ask your doctor when to expect the results.

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