Thoracentesis (pleural tap) is a procedure to remove excess fluid from the space between the lungs and the chest wall. This space is called the pleural space. The procedure is done with a needle or a plastic catheter that is inserted through the chest wall. Thoracentesis may be done for diagnostic and/or therapeutic reasons. 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.
Thoracentesis may be done to figure out the cause of pleural effusion and/or relieve the symptoms caused by the buildup of fluid. This procedure may also be done to diagnose systemic lupus erythematosus (SLE), pancreatitis, pulmonary embolism, empyema, and tuberculosis. The most common reasons for why you may need a thoracentesis include: Pleural effusion - Thoracentesis may be done to figure out the cause of new fluid build-upin the chest. Infection - When an infection is suspected to be the cause of fluid build-up in the chest, a thoracentesis may be done to help make a diagnosis. Fluid that is drained can be analyzed in the laboratory to identify the type of pathogen causing the infection and what medicines might be effective. -Cancer - Some cancers spread to the lung or the pleura (the lining of the lung and chest wall). This can cause fluid to build up in the chest. A thoracentesis may be done to help make a diagnosis. Fluid that is drained can be examined in the laboratory to see if cancer cells are present. -Comfort - A large build up of fluid can be painful and make it hard to breathe. Removing some fluid may make the person more comfortable.
-Thoracentesis is generally a safe procedure. -No surgical incision is needed. -It can be performed to relieve discomfort as well as allow doctors to obtain samples
-Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
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.
A chest x-ray, ultrasound or computed tomography (CT) scan is usually done to confirm 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.
An x-ray may be taken immediately after the procedure to make sure that no complications has occurred and that the procedure was successful. Most patients are able to return to normal activities after the procedure.
Pain- This can can result from the needle at the time it is inserted. Doctors try to lessen any pain or discomfort by giving a local numbing medicine (topical anesthetic). The discomfort is usually mild and goes away once the needle or tube is removed. Pneumothorax. This can occur when the needle accidentally punctures the lung when it is being placed. Air trapped in the pleural space may cause the lung to collapse. Bleeding - During 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 - A thoracentesis may also cause potential infections as it involves the penetration of skin.
What are the recommendations for travel for this procedure?
If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).
What is the follow up procedure like?
After the procedure is over, your vitals will be monitored, and you may have an X-ray of your lungs taken. Your doctor will allow you to go home if your breathing rate, oxygen saturation, blood pressure, and pulse are all good. Most people who have a thoracentesis can go home the same day. You’ll be able to return to most of your normal activities soon after the procedure. However, your doctor may recommend that you avoid physical activity for several days after the procedure. Your doctor will explain how to take care of the puncture site. Make sure to call your doctor if you begin to have any signs of infection. Symptoms of infection include: trouble breathing coughing up blood fever or chills pain when you take deep breaths redness, pain, or bleeding around the needle site