Thoracentesis

Thoracentesis is a procedure that is done to remove a sample of fluid from around the lung. The lung is covered with a tissue called the pleura. The inside of the chest is also lined with pleura. The space between these two areas is called the pleural space. This space normally contains just a thin layer of fluid, however, some conditions such as pneumonia, cancer, or congestive heart failure may cause excessive fluid to develop.

Thoracentesis involves placing a thin needle or tube into the pleural space to remove some of the fluid. The needle or tube is inserted through the skin, between the ribs and into the chest. This procedure may be done to remove fluid for testing or for treatment. The needle or tube is removed when the procedure is completed. If a person needs more fluid drained, sometimes the tube is left in place for a longer time.

Why do I need a thoracentesis?

New pleural effusion – to figure out the cause of fluid buildup
Infection – to assist in making the diagnosis and choosing appropriate antibiotics
Cancer – to diagnose whether cancer has spread into that part of the chest
Comfort – a large build up of fluid can make it hard to breath. Removing the fluid may make the person more comfortable.

What are the risks of a thoracentesis?

Risks are not common and not usually serious
Pain during placement – this is reduced with the use of numbing medications
Bleeding – usually minor and stops on its own, but sometimes may require a chest tube or surgery
Collapsed lung – unintentional hole in the lung usually seals quickly on its own. May require a chest tube. Risk of this occurring has been significantly reduced by the use of Ultrasound to guide the procedure.

Preparation for a thoracentesis:

Usually a Chest x-ray , chest CT or ultrasound is done prior to the procedure to evaluate how much fluid has built up around the lung
Blood tests may be drawn to assess risk of bleeding
You may be asked to stop certain medications (blood thinners)

How is a thoracentesis performed?

You will be asked to sit up and lean over a table (see picture)
The area between the ribs is marked and the skin is cleaned and disinfected
Numbing medication is injected under the skin and into the deeper tissues
A needle is inserted into the pleural space, over which the doctor slides a small plastic tube
The tube is removed once an adequate sample is obtained and/or the space is completely drained.
A small bandage is place over the insertion site.
There are no specific limitations after the procedure is completed.

Procedure Index