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Thoracentesis

Pleural fluid aspiration; Pleural tap

 

Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest.

How the Test is Performed

 

The test is done in the following way:

  • You sit on a bed or on the edge of a chair or bed. Your head and arms rest on a table.
  • The skin around the procedure site is cleaned. A local numbing medicine (anesthetic) is injected into the skin.
  • A needle is placed through the skin and muscles of the chest wall into the space around the lungs, called the pleural space. The health care provider may use ultrasound to find the best spot to insert the needle.
  • Fluid is drawn out with the needle.
  • The fluid may be sent to a laboratory for testing ( pleural fluid analysis ).

 

How to Prepare for the Test

 

No special preparation is needed before the test. A chest x-ray  or ultrasound will be done before and after the test.

DO NOT cough, breathe deeply, or move during the test to avoid injury to the lung.

 

How the Test will Feel

 

You will feel a stinging sensation when the local anesthetic is injected. You may feel pain or pressure when the needle is inserted into the pleural space.

Tell your provider if you feel short of breath or have  chest pain .

 

Why the Test is Performed

 

Normally, very little fluid is in the pleural space. A buildup of too much fluid between the layers of the pleura is called a pleural effusion .

The test is performed to determine the cause of the extra fluid, or to relieve symptoms from the fluid buildup.

 

Normal Results

 

Normally the pleural cavity contains only a very small amount of fluid.

 

What Abnormal Results Mean

 

Testing the fluid will help your provider determine the cause of pleural effusion. Possible causes include:

  • Cancer
  • Liver failure
  • Heart failure
  • Low protein levels
  • Kidney disease
  • Trauma or post-surgery
  • Asbestos-related pleural effusion
  • Collagen vascular disease (class of diseases in which the body's immune system attacks its own tissues)
  • Drug reactions
  • Collection of blood in the pleural space (hemothorax)
  • Lung cancer  
  • Swelling and inflammation of the pancreas ( pancreatitis )
  • Pneumonia
  • Blockage of an artery in the lungs (pulmonary embolism)
  • Severely underactive thyroid gland

If your provider suspects that you have an infection, a culture of the fluid may be done to test for bacteria.

 

Risks

 

Risks may include any of the following:

  • Bleeding
  • Infection
  • Pneumothorax
  • Respiratory distress

 

Considerations

 

A chest x-ray is commonly done after the procedure to detect possible complications.

 

 

References

Alder EH, Blok BK. Thoracentesis. In: Roberts JR, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 9.

Chernecky CC, Berger BJ. Thoracentesis - diagnostic. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures . 6th ed. St Louis, MO: Elsevier Saunders; 2013:1068-1070.

 

        Tests for Thoracentesis

         

         

        Review Date: 8/21/2016

        Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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