Thoracocentesis is a procedure performed by a doctor to remove fluid from the pleural space, which is the part between the membrane that covers the lung and the ribs. This fluid is collected and sent to a laboratory to diagnose an illness, but it also serves to relieve symptoms, such as shortness of breath and chest pain, caused by the accumulation of fluid in the pleural space.
It is usually a quick procedure and does not require much time for recovery, but in some cases redness, pain and leakage of fluid from the place where the needle is inserted may occur, and it is necessary to inform the doctor.
what is it for
Thoracentesis, also called pleural drainage, is indicated to relieve symptoms such as pain when breathing or shortness of breath caused by a lung problem. However, this procedure may also be indicated to investigate the cause of fluid accumulation in the pleural space.
This buildup of fluid on the outside of the lung is called pleural effusion and happens because of some conditions, such as:
- Congestive heart failure;
- Virus, bacterial or fungal infections;
- Lung cancer;
- Blood clot in the lung;
- Systemic lupus erythematosus;
- severe pneumonia;
- Drug reactions.
The general practitioner or pulmonologist can identify the pleural effusion through tests such as X-ray, computed tomography or ultrasound and may indicate the performance of thoracentesis for other reasons, such as performing a biopsy of the pleura.
how is it done
Thoracocentesis is a procedure performed in the hospital or clinic by a general practitioner, pulmonologist, or general surgeon. Currently, the use of ultrasound is indicated at the time of thoracentesis, so that the doctor knows exactly where the fluid is accumulating, but in places where the use of ultrasound is not available, the doctor is guided by the imaging tests performed before of the procedure, such as an X-ray or CT scan.
Thoracocentesis is usually done in 10 to 15 minutes, but it can take longer if there is a lot of fluid in the pleural space. The procedure steps are:
- Remove jewelry and other objects and put on a hospital gown with an opening in the back;
- Devices will be installed to measure heart rate and blood pressure, as well as the nursing team will be able to put on a nasal tube or mask to guarantee more oxygen to the lungs;
- Sitting or lying on the edge of a stretcher with your arms elevated, as this position helps the doctor better identify the spaces between the ribs, which is where he will place the needle;
- The skin is cleaned with an antiseptic product and an anesthetic is applied to the place where the doctor will pierce it with the needle;
- After the anesthesia takes effect on the site, the doctor introduces the needle and slowly withdraws the liquid;
- When the fluid is removed, the needle will be removed and a bandage will be placed on the site.
Once the procedure is over, a sample of the fluid is sent to the lab and an X-ray can be taken so the doctor can see the lungs.
The amount of fluid drained during the procedure depends on the condition, and in some cases, the doctor may place a tube to drain more fluid, known as a drain. Learn more about what a drain is and the necessary care.
Before the end of the procedure, signs of bleeding or fluid leakage are checked. When none of these signs are present, the doctor sends you home, however it is necessary to warn in case of fever above 38°C, redness in the place where the needle was inserted, if there is blood or fluid leaking, shortness of breath or pain in the chest.
Most of the time, you have no dietary restrictions at home, and your doctor may ask you to stop some physical activities.
Thoracocentesis is a safe procedure, especially when performed with the help of ultrasound, but some complications can happen and vary according to the person’s health and the type of disease.
The main complications of this type of procedure can be bleeding, infection, pulmonary edema or pneumothorax. It can happen to cause some damage to the liver or spleen, but these are very rare.
In addition, chest pain, dry cough and fainting sensation may occur after the procedure, so it is always necessary to keep in touch with the doctor who performed the thoracentesis.
Thoracentesis is a procedure that can be performed for most people, but in some cases it may be contraindicated, such as having blood clotting problems or having some bleeding.
In addition, it is necessary to notify the doctor who will perform the test in situations of pregnancy, allergy to latex or anesthesia or use of blood thinning drugs. You should also follow the recommendations made by the doctor before the procedure, such as stopping taking any medication, fasting and taking imaging tests performed before thoracentesis.
Always consult a doctor.
Verified by RJ985 – Brazilian natural medicine CMIO.org