THORACENTESIS

Thoracentesis (also referred to as Pleural fluid aspiration or Pleural tap) is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest. Normally, very little fluid is present in this space. An accumulation of excess fluid between the layers of the pleura is called a pleural effusion.

THE THORACENTESIS PROCEDURE

A small area of skin on your chest or back is washed with a sterilizing solution. Some numbing medicine (local anesthetic) is injected in this area. A needle is then placed through the skin of the chest wall into the space around the lungs called the pleural space. Fluid is withdrawn and collected and may be sent to a laboratory for analysis (pleural fluid analysis).

PREPARING FOR THE PROCEDURE

No special preparation is needed before the procedure. A chest x-ray is may be performed before and after the test.

Do not cough, breathe deeply, or move during the test to avoid injury to the lung.

DURING THE PROCEDURE

You will sit on the edge of a chair or bed with your head and arms resting on a table. The skin around the procedure site is disinfected and the area is draped. A local anesthetic is injected into the skin. The thoracentesis needle is inserted above the rib into the pleural space.

There will be a stinging sensation when the local anesthetic is injected, and you may feel a sensation of pressure when the needle is inserted into the pleural space.

Inform your health care provider if you develop shortness of breath or chest pain.

WHY THE TEST IS BEING PERFORMED

The test is performed to determine the cause of the fluid accumulation or to relieve the symptoms associated with the fluid accumulation.

NORMAL VALUES

Normally the pleural cavity contains less than 20 milliliters of serous fluid.

ABNORMAL VALUES

The analysis of the fluid will indicate possible causes of pleural effusion such as infection, cancer, heart failure, cirrhosis, and kidney disease. If infection is suspected, a culture of the fluid is often done to determine whether microorganisms are present and if so, to identify them.

Additional conditions under which the test may be performed include the following:

•  Pneumonia

•  Hemothorax

•  Pulmonary veno-occlusive disease

•  Pancreatitis

•  Pulmonary embolism

•  Thyroid disease

•  Collagen vascular disease

•  Asbestos-related pleural effusion

•  Drug reactions

POTENTIAL RISKS

•  Pneumothorax (collapse of the lung)

•  Fluid re-accumulation

•  Pulmonary edema

•  Bleeding

•  Infection

•  Respiratory distress