Thoracentesis Overview

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

Prior to Procedure

Your doctor may order:

• A complete physical exam

• X-ray —a test that uses radiation to take a picture of structures inside the body

• CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body

• Ultrasound—uses sound waves to make pictures of the inside of the body

• Blood tests

Anesthesia

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

Description of the Procedure

You will usually be asked to sit upright on the edge of a bed or chair. Your arms will be resting on a nearby table. The doctor may use ultrasound to mark the location of the pleural fluid. A small patch of skin on your back, chest, or under your armpit will be sterilized. Anesthesia will be applied to help numb the area. A needle will be inserted between your ribs and into the pleural space. A thin plastic catheter may be used, as well. You should avoid coughing, breathing deeply, or moving during the procedure. Some or all of the fluid will be drawn into the syringe.

Placement of Thoracentesis Needle © 2009 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 doctor or nurse if you feel extreme pain, any shortness of breath, or faint.

Post-procedure Care

At the Care Center

If 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.

At Home

Keep the area of skin where the needle was inserted clean and dry. To help make your recovery smooth, be sure to follow your doctor's instructions.

If a diagnostic thoracentesis was done, ask your doctor when to expect the results.

RESOURCES:

American Lung Association
http://lungusa.org/

American Thoracic Society
http://www.thoracic.org/

CANADIAN RESOURCES:

The Canadian Institutes of Health Information
http://www.cihi.ca/cihiweb/

The Canadian Lung Association
http://www.lung.ca/

References:

Harrison’s Principles of Internal Medicine. 16th ed. McGraw-Hill; 2005.

Mason RJ. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. WB Saunders; 2005.

Roberts JR. Clinical Procedures in Emergency Medicine. 4th ed. WB Saunders; 2004.