What you need to know about:

Thoracentesis (Pleural Tap)

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Overview of

Thoracentesis (Pleural Tap)

in Thailand

Thoracentesis (also known as a pleural tap) is a minimally invasiveprocedure performed in order to remove excess fluid from the space between the lungs and the chest wall, known as the pleural space. The procedure is done with a needle or a plastic catheter that is inserted through the chest wall. Normally there is a small amount of fluid in the pleural space, but a buildup of excess fluid, known as pleural effusion, may occur due to infection, inflammation, heart failure, or cancer. A large amount of fluid in the pleural space can also make it difficult to breathe and cause pain. A thoracentesis may be done for diagnostic and/or therapeutic reasons.

Goals of

Thoracentesis (Pleural Tap)

A thoracentesis is performed to:  

-Help relieve pressure on the lungs from air or from fluids in the pleural space

-Treat symptoms such as shortness of breath and pain

-Act as a diagnostics tool in order to determine the cause of excess fluid in the pleural space. This procedure may also be done to diagnose systemic lupus erythematosus (SLE), pancreatitis, pulmonary embolism, empyema, and tuberculosis.

Price of

Thoracentesis (Pleural Tap)

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Pros and cons of

Thoracentesis (Pleural Tap)

Pros

-A thoracentesis may be done to figure out the cause of pleural effusion and/or relieve the symptoms caused by the buildup of fluid.

-The procedure is minimally invasive and can be done as an outpatient procedure  

Cons

-The procedure is not a definitive method in treating the condition or diseases that causes the pleural effusion. Additional procedures might need to be performed later.

How it works:

Thoracentesis (Pleural Tap)

You will be positioned in a sitting position and will lean forward over a table or a padded surface. The site for insertion of the needle, which will be between your ribs on your back, will be cleaned. A local anesthetic will then be injected. A long needle or catheter will then be inserted into the pleural space. Ultrasound may be used to guide the needle or catheter. The procedure usually takes 10 to 15 minutes, but may take longer if a large amount of fluid must be removed. The needle or catheter may be attached to a container to hold the fluid if a lot of it has to be removed. After the needle or catheter is removed, a bandage will be placed on the site.

Preparation before

Thoracentesis (Pleural Tap)

Pre - treatment

A chest x-ray, ultrasound or computed tomography (CT) scan is usually done to confirm the presence of a pleural effusion, which may be found during a physical examination. Please let your doctor know about all medication that you are taking as some may need to be stopped before the procedure. Also, let your doctor know if you are allergic to medication and/or medical equipment. You may need someone to drive you home if a sedative is used during the procedure.

Recovery after

Thoracentesis (Pleural Tap)

Post - treatment

An x-ray may be taken immediately after the procedure to make sure that no complications have occurred and that the procedure was successful. Most patients are able to return to normal activities after the procedure.

Risks & side effects

-Collapsed lung (pneumothorax). —When the needle is being placed, it may puncture the lung. This hole may seal quickly on its own. If the hole does not seal over, air can leak out and build up around the lung. This build-up of air can cause part or all of the lung on that side to collapse (pneumothorax). If this happens, the doctor can place a chest tube between the ribs into the chest to remove the air that is leaking from the lung when air is trapped in the pleural space, causing the lung to collapse. -Pulmonary edema, which is fluid in the lungs. -Bleeding. During the insertion of the needle, a blood vessel in the skin or chest wall may be accidentally nicked. Bleeding is usually minor and stops on its own. Sometimes, bleeding can cause a bruise on the chest wall. Rarely, bleeding can occur into or around the lung and may require a chest tube or surgery -Infection.

FAQs:

Thoracentesis (Pleural Tap)

What is the likelihood of success?

If there is a lot of fluid in the pleural space, after the procedure the patient’s breathing will slowly improve. Normally, removing this fluid and examining it in the laboratory allows for diagnosis in 75% of patients.

What are the indications for a thoracentesis?

1. A diagnostic thoracentesis indicated for almost all patients who have pleural fluid that is new or of uncertain etiology and is ≥ 10 mm in thickness on computed tomography (CT) scan, ultrasonography, or lateral decubitus x-ray. Diagnostic thoracentesis is usually not needed when the etiology of the pleural fluid is apparent (eg, viral pleurisy, typical heart failure).  2. A therapeutic thoracentesis is performed in order to relieve symptoms in patients with dyspnea caused by a large pleural effusion. If pleural fluid continues to reaccumulate after several therapeutic thoracenteses, pleurodesis (injection of an irritating substance into the pleural space, which causes obliteration of the space) may help prevent recurrence. Alternatively, placement of an indwelling pleural catheter can allow drainage of pleural fluid by patients at home. Pleurodesis and placement of an indwelling pleural catheter are most commonly done to manage malignant effusions.

What are limitations of a thoracentesis?

Thoracentesis may not be performed on patients who have an uncorrectable bleeding disorder. The accuracy of a thoracentesis may be affected by a patient's: use of antibiotics and inability to remain still throughout the procedure.

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