What Is Thoracentesis?
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?
During a thoracentesis procedure, you are typically positioned sitting on a bed or the edge of a chair; however, if needed, the patient can be rolled onto their side while lying down with the affected side facing up. The skin around the procedure site is thoroughly cleaned, and a local anesthetic is injected to numb the area. A needle is then carefully inserted through the skin and muscles of the chest wall into the pleural space, with the healthcare provider potentially utilizing ultrasound guidance for precise needle placement. Fluid is withdrawn from the pleural space using suction or vacuum assistance. Once the desired amount of fluid is collected, the needle is removed, and the area is securely bandaged. Any fluid obtained may be sent to a laboratory for further analysis, known as pleural fluid analysis.
What should I expect?
What should you expect during the procedure? Prior to the procedure, you might be asked to withhold certain medications. Throughout the process, you may be requested to hold your breath briefly or refrain from coughing to prevent any disruption to the catheter. As the fluid is drained, you might feel discomfort in your chest or shoulder, and coughing may occur. These sensations could persist even after the procedure as your lung re-expands.
Recovery
What is the expected recovery time after the procedure? Generally, any symptoms you may encounter during or after the procedure should alleviate within 1-2 hours. It’s advisable to refrain from engaging in strenuous activities for the next 48 hours to facilitate proper healing. You can remove the bandage after 24 hours, but keep an eye out for any fluid leakage from the site. If the drainage becomes cloudy or the site appears reddened, it’s crucial to inform your healthcare provider promptly. Additionally, if you experience heightened shortness of breath or pain following the procedure, seek immediate medical attention.
Possible Risks/Complications
Although generally considered a low-risk intervention, complications of thoracentesis include pneumothorax, bleeding (puncture site bleeding, chest wall hematoma, and hemothorax), and re-expansion pulmonary edema (REPE).