(Pleural Fluid Aspiration; Pleural Tap)
Definition
Definition
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
Reasons for Procedure
Reasons for Procedure
There is always a small amount of fluid in the pleural space. The fluid helps to lubricate the area. When too much fluid builds up in this space, it can make it difficult to breathe.
Your doctor may want to test some of the fluid after removing it. The build-up of fluid can be a symptom of diseases or disorders, such as:
- Heart failure
- Lung infections
- Kidney disease
- Pulmonary embolism—a clot that travels to the lung
- Cancer
- Collagen vascular disease like sarcoidosis or lupus
- Liver disease
- Pancreatitis
- Asbestos exposure
Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Collapsed lung
- Fluid building up again
- Bleeding
- Infection
- Damage to the lung, liver or spleen
Factors that may increase the risk of complications include:
What to Expect
What to Expect
Prior to Procedure
Your doctor may order:
Anesthesia
A local anesthetic will be used. It will numb the area where the needle will be inserted.
Description of the Procedure
You may be asked to sit upright on the edge of a bed or chair. Your arms will be resting on a nearby table. If your procedure involves a CT scan, you may be asked to lie on a table. Try to avoid coughing, breathing deeply, or moving during the procedure.
A small patch of skin on your back, chest, or under your armpit will be sterilized. Anesthesia will be applied to this patch. It will help numb the area.
The doctor may use ultrasound or CT scan images to guide the needle and monitor the fluid. A needle or thin plastic catheter will be inserted between your ribs. The needle or catheter is then passed into the pleural space. Some or all of the fluid will be drawn into the syringe.
Placement of Thoracentesis Needle© 2011 Nucleus Medical Media, Inc.
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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 healthcare team 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.
The doctor may begin treatment for the cause of the fluid build-up.
At Home
Keep the area of skin where the needle was inserted clean and dry to avoid infection. You may have your activity restricted during your recovery.
If a diagnostic thoracentesis was done, ask your doctor when to expect the results.
Call Your Doctor
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the insertion site
- Pain that you cannot control with the medicatons you’ve been given
- Cough, shortness of breath, or chest pain
- Coughing up blood
- Pain when taking a deep breath
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Thoracic Society http://patients.thoracic.org
CANADIAN RESOURCES:
The Lung Association http://www.lung.ca
References:
http://www.nhlbi.nih.gov/health/health-topics/topics/thor
Updated February 24, 2012. Accessed February 18, 2015.
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.
Thoracentesis. Johns Hopkins Medicine website. Available at:
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/thoracentesis_92,P07761
Accessed February 18, 2015.
Thoracentesis. The Merck Manual Professional Edition website. Available at:
http://www.merckmanuals.com/professional/pulmonary_disorders/diagnostic_pulmonary_procedures/thoracentesis.html
Updated September 2013. Accessed February 18, 2015.
6/3/2011 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed
: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last Updated: 3/15/2013