Thoracentesis 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 any disease, 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.
Generally, it is a quick procedure and does not require much time to recover, but in some cases redness, pain and leakage of liquids may occur from the place where the needle is inserted, 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 can also be indicated to investigate the cause of the accumulation of fluids in the pleural space.
This accumulation of fluid on the outside of the lung is called pleural effusion and happens because of some diseases, such as:
- Congestive heart failure; Infections by viruses, bacteria or fungi; Lung cancer; Blood clot in the lung; Systemic lupus erythematosus; Tuberculosis; Severe pneumonia; Reactions to medications.
The general practitioner or pulmonologist can identify the pleural effusion through exams such as X-ray, computed tomography or ultrasound and can indicate the performance of thoracentesis for other reasons, such as biopsy of the pleura.
How it is done
Thoracentesis is a procedure performed at the hospital or clinic by a general practitioner, pulmonologist or general surgeon. Currently, the use of ultrasound is indicated at the time of thoracentesis, because the doctor knows exactly where the liquid is accumulating, but in places where the use of ultrasound is not available, the doctor is guided by the image exams done before of the procedure, such as an X-ray or tomography.
Thoracentesis is usually done in 10 to 15 minutes, but it may take longer if there is too much fluid in the pleural space. The procedure steps are:
- Remove jewelry and other objects and put a hospital garment with an opening in the back; Devices will be installed to measure the heartbeat and blood pressure, as well as the nursing staff can put a nasal tube or mask to ensure more oxygen to the lungs; Sitting or lying on the edge of a stretcher with arms raised, as this position helps the doctor to better identify the spaces between the ribs, which is where he will place the needle; The skin is cleaned with antiseptic product and applied anesthesia at the place where the doctor will pierce with the needle; After the anesthesia takes effect at the place, the doctor introduces the needle and withdraws the liquid slowly; When the liquid is removed, the needle will be removed and a dressing will be placed on the place.
As soon as the procedure is finished, a sample of the liquid is sent to the laboratory and an X-ray can be performed for the doctor to see the lungs.
The amount of fluid drained during the procedure depends on the disease and, in some cases, the doctor may place a tube to drain more fluids, known as a drain. Learn more about what is a drain and the necessary care.
Before the end of the procedure, there are signs of bleeding or leakage of liquid. When there are none of these signs, the doctor will release 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 leaking blood or liquid, shortness of breath or pain in the chest.
Most of the time, there are no restrictions on diet at home and the doctor may ask that some physical activities be suspended.
Possible complications
Thoracentesis is a safe procedure, especially when performed with the aid 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, after the procedure, chest pain, dry cough and fainting sensation may appear, so it is always necessary to keep in touch with the doctor who performed the thoracentesis.
Contraindications
Thoracentesis is a procedure that can be performed for most people, but in some cases it can be contraindicated, such as having blood clotting problems or having some bleeding.
In addition, it is necessary to inform the doctor that you are going to be tested in situations of pregnancy, allergy to latex or anesthesia or use of blood thinning medications. One should also follow the recommendations made by the doctor before the procedure, such as stopping taking medication, keep fasting and take imaging tests done before thoracentesis.
