Thoracentesis is a procedure to remove excess fluid from the pleural space surrounding your lungs' outer lining (pleural membrane) and the inner lining of your chest wall. The pleural space generally contains a small amount of fluid to prevent the double-layered pleural membranes from rubbing against each other. When the fluid quantity increases (pleural effusion), it causes breathing difficulties and requires a thoracentesis procedure to drain the extra fluid. It can also diagnose the following conditions:
Alternate Name of Thoracentesis
Pleurocentesis or pleural tap
Pleural space surrounding the lungs
How is Thoracentesis Performed?
At first, the nurse or doctor will ask you to comfortably sit on the edge of a chair or bed with your arms and head resting on a table. They will administer oxygen through a cannula or mask in your nose. The doctor then sterilises the needle insertion point on your skin (above your ribs' upper edge) with an antiseptic. After sterilisation, they will inject a local anaesthetic to numb the area.
They will now insert the needle through the skin between your ribs and chest wall muscles so it reaches the pleural space. A connected ultrasound device may guide it to the desired location. Once it reaches the correct position, the doctor uses a suction device or a syringe to draw the fluid into a bag or bottle.
After drawing it out, the doctor will carefully remove the needle, apply pressure to stop the bleeding, and cover the incision site with a bandage or dressing. The fluid collected is sent to the laboratory for further testing.
Stay calm and still during the procedure. The doctor may ask you to hold your breath at certain times. The entire process generally takes around 15 minutes.
Thoracentesis Procedure type
Preparation for Thoracentesis
Here is a checklist of things to consider before the procedure:
Diet: Unless the doctor has specifically instructed, there are no dietary restrictions to consider. However, cut back on alcohol and tobacco.
Medications and medical conditions: Talk to your doctor about your recent illnesses, underlying medical conditions like allergies or bleeding disorders, and medications you regularly consume, such as blood thinners, multivitamins, herbal supplements, or anti-inflammatory drugs. Inform your doctor if you are pregnant.
Time of admission: Thoracentesis is usually a part of an outpatient procedure completed on the same day.
Pre-operative tests: The doctor may ask you to undertake imaging tests, such as chest X-rays, CT scans, or ultrasounds, to ascertain the fluid quantity.
Consent form: Before signing the consent form, ensure you clear your doubts regarding the benefits and risks of the procedure.
Clothing and accessories: The hospital will provide you with a gown. Remove your jewellery, spectacles, contact lenses, dentures, and other accessories. Ask family or a friend to drive you home after the procedure.
Follow up After Thoracentesis
Right after the procedure, the healthcare team at the hospital or clinic will monitor you for vital signs, such as blood pressure, pulse, oxygen saturation levels, and heart rate. The doctor will check the bandaged puncture site for bleeding or signs of infection. They might ask you to get another chest X-ray to examine the condition of your lungs post the procedure. After the lab tests the pleural fluid, the doctor will write a report based on the presence or absence of infection or lung disease. You will receive a follow-up appointment call to discuss the thoracentesis results with your physician.
You may undergo coughing spells up to a couple of hours after thoracentesis as it helps your lungs to expand to their regular size. However, you must contact your healthcare provider immediately if you experience a recurring fever of more than 100.4 degrees Fahrenheit, inflammation, swelling at the puncture site, difficulty breathing, chest pain, or coughing up blood.
Risks Factors of Thoracentesis
Like any other medical procedure, thoracentesis comes with its own set of risks and complications, which are listed below:
Bleeding: During the needle insertion, a blood vessel may accidentally rupture. It leads to bleeding around the area, which usually stops after a while.
Pain at the puncture site: You may experience pain at the puncture site where the doctor inserted the needle, even after the anaesthetic application. The pain is short-lived and generally subsides in some time.
Infection: At times, bacterial infections might set in because of the entry of bacteria through the break in your skin.
Lung collapse: During needle insertion, an accidental lung rupture may cause air to escape into the thoracic cavity. This air build-up (pneumothorax) can lead to lung collapse.
Pulmonary oedema: If the fluid drains too fast, it can accumulate in your lungs instead, causing oedema.
Recovery After Thoracentesis Procedure
The recovery period for thoracentesis is short, usually 24-48 hours. Individuals who develop complications may take longer to heal. Learn the correct way to care for the wound at the incision site post the procedure. You can remove the dressing after 48 hours. You may resume your regular diet unless recommended otherwise. Avoid tiring physical activities and strenuous exercise for some days. Ask your healthcare provider how soon you can return to daily activities like work or studies. Individuals who have medical conditions causing frequent pleural effusions may require multiple thoracentesis procedures.