A thoracentesis is a procedure performed to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest. It is usually performed with ultrasound guidance.
Why is it done?
A thoracentesis can be performed when you have a pleural effusion (fluid between your lung and chest wall). It is done diagnostically whenever the excessive fluid is of unknown etiology. A thoracentesis can also be done therapeutically whenever the volume of fluid is causing significant clinical symptoms (such as shortness of breath).
How is it performed?
Typically you are positioned sitting on a bed or on the edge of a chair. ( if unable, the patient can be rolled on their side while lying down and the affected side is up).
The skin around the procedure site is cleaned. A local numbing medicine (anesthetic) is injected into the skin.
A needle is placed through the skin and muscles of the chest wall into the space around the lungs, called the pleural space. The health care provider may use ultrasound to find the best spot to insert the needle.
Fluid is drawn out with the needle using suction or vacuum assistance.
The needle is removed and the area is bandaged.
The fluid may be sent to a laboratory for testing (pleural fluid analysis)
What should I expect?
You may be asked to hold certain medications in preparation of your procedure.
During the procedure, you may be asked to hold your breath for short periods of time or to avoid coughing as this may dislodge the catheter.
As the fluid is being removed, you may experience discomfort in your chest or shoulder, or experience coughing; these symptoms may last even after the procedure is over and are a result of your lung reexpanding.
What is my recovery time?
Typically any symptoms you experience during or after your procedure should dissipate in 1-2 hours.
Avoid strenuous activity for 48 hours.
The bandage may be removed in 24 hours. Some fluid leakage from the site may be experienced, if the drainage becomes cloudy or the site becomes reddened; notify your provider.
If you develop increased shortness of breath or pain post procedure, seek immediate medical attention.
Possible Risks/Complications
Although generally considered a low-risk intervention, complications of thoracentesis, including pneumothorax, bleeding (puncture site bleeding, chest wall hematoma, and hemothorax), and re-expansion pulmonary edema (REPE)
