A buildup of fluid in your pleural space is called pleural effusion. Pleural effusion can compress your lungs and cause difficulty breathing. Thoracentesis is a minimally invasive procedure that involves inserting a needle into the pleural space around your lungs.
The goal is to drain fluid or air in order to make it easier for you to breathe. In some cases, the procedure will also help your doctor discover the cause of your fluid buildup.
After thoracentesis, a lab test called a pleural fluid analysis may be performed to figure out the cause of fluid accumulation around one or both of your lungs. Your doctor may also perform a pleural biopsy. Though not commonly performed, it can help identify the underlying cause of pleural effusion. Potential causes include:. Thoracentesis is performed in people with pleural effusion to either improve breathing or help make a diagnosis.
The American Thoracic Society says that the most common reasons to perform thoracentesis are:. Some people may not be able to safely undergo thoracentesis. You might not be a good candidate for thoracentesis if you have insufficient pleural fluid or a skin infection or wound at the needle insertion site. However, speak with your doctor if you have any questions or concerns about the procedure. Also, tell your doctor if you:. Every invasive procedure has risks, but side effects are uncommon with thoracentesis.
Possible risks include:. Research has found that ultrasound guidance lowers the risk of complications. A study found a 1. In comparison, there is a 10 to 18 percent risk of a collapsed lung when undergoing thoracentesis without imaging. After the procedure is over, your doctor will monitor your vitals and may order an X-ray of your lungs. They will allow you to go home if your breathing rate, oxygen saturation, blood pressure, and pulse are all good.
Are sensitive to or allergic to any medicines, latex, tape, or anesthetic medicines local and general. Take any medicines, including prescriptions, over-the-counter medicines, vitamins, herbs, and other supplements. Take blood-thinning medicine anticoagulant , aspirin, or other medicines that affect blood clotting. Stop taking certain medicines before the procedure, if instructed by your healthcare provider.
You may have imaging tests before the procedure. These are done to find the location of the fluid to be removed. You may have any of the below:. You may have your procedure as an outpatient. This means you go home the same day. Or it may be done as part of a longer stay in the hospital. The way the procedure is done may vary. It depends on your condition and your healthcare provider's methods. In most cases, a thoracentesis will follow this process:. You may be asked to remove your clothes.
If so, you will be given a hospital gown to wear. You may be asked to remove jewelry or other objects. You may be given oxygen through a nasal tube or face mask. Your heart rate, blood pressure, and breathing will be watched during the procedure. You will be in a sitting position in a hospital bed. Your arms will be resting on an over-bed table. This position helps to spread out the spaces between the ribs, where the needle is inserted.
If you are not able to sit, you may lie on your side on the edge of the bed. When the area is numb, the healthcare provider will put a needle between the ribs in your back. You may feel some pressure where the needle goes in. Fluid will slowly be withdrawn into the needle. Then, your healthcare provider will give you an injection shot in this area of a local anesthetic medication to make an area numb.
Next, your healthcare provider will insert a needle through the numbed area into your pleural cavity. You may be asked to breathe out or hold your breath at different times during the procedure. Once the needle is in the fluid, a catheter thin, flexible tube will be placed through it, and the needle will be taken out. Then suction or vacuum bottles will be used to help take the fluid out of your body.
You may feel discomfort or pain in your shoulder or the area where the needle was inserted. This might happen toward the end of your procedure. Let your healthcare provider know if you feel a lot of pain and they may pause the procedure.
You will most likely stay in the procedure or exam room until all of the fluid has drained, or if your healthcare provider feels like enough has drained.
Your healthcare provider will remove the catheter when this is done. Coughing after the thoracentesis procedure is normal. It should stop after about an hour. You may have a small amount of fluid leaking from the site. Your nurse will give you extra gauze to put over your bandage to protect your clothing in case this happens. Once the thoracentesis is done, you will have a chest x-ray.
This is to make sure that all the fluid was taken out and that your lungs are working the way they should be. You will be able to go home after your x-ray is done. During this time, you must keep the bandage dry.
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