Thoracentesis

A thoracentesis is a procedure that removes excess fluid from the pleural space called a pleural effusion. This space is between the outside surface of the lungs and the chest wall. A catheter (a long, thin, hollow plastic tube) is inserted into the pleural space to obtain the pleural fluid. A sample of fluid may be obtained for testing to help determine the cause. Or, if you are having symptoms such as trouble breathing, it may also be done to drain the excess fluid to improve symptoms.

Before the Procedure

  • No food or liquids for 2 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
  • It is required that you arrange for a relative or friend to drive you home after the procedure.
  • Report any medications you are taking to the radiology nurse, including “blood thinners”, such as aspirin, Plavix, Lovenox, Coumadin, Pradaxa, Xarelto, or Eliquis. Your physician may advise you to stop taking a “blood thinner” for a specific period of time before your procedure.
  • If you are taking Coumadin or Heparin, or you have known or suspected liver disease, your blood will be tested to determine if your blood clots normally.
  • Report any allergies to the radiology nurse, especially those to local anesthetic medications.

During the Procedure

  • You will be positioned sitting up on the ultrasound table and images will be taken to locate the site of the excess fluid inside your chest and decide where to insert the catheter.
  • The skin of the chest is cleaned with an antiseptic solution and the area is covered with a large sterile sheet.
  • You will feel a slight pin prick when the local anesthetic (numbing medicine) is injected in the skin.
  • The doctor then carefully inserts the catheter through the skin and in between two ribs into the pleural space. The catheter will fill with fluid. A tube may be attached to the catheter so that all of the excess fluid can be drained.
  • Once the fluid is drained, the catheter is removed.
  • A chest x-ray will be performed after the thoracentesis to detect any complications.

Potential Risks and Complications

  • Bleeding at the procedure site
  • Infection at the procedure site
  • Injury to an adjacent nerve, blood vessel, or muscle
  • Fast drop in blood pressure
  • A pneumothorax or a partial collapse of the lung may occur
  • Fluid in the lung may occur if too much fluid is removed

After the Procedure

  • You must stay in the company of a responsible adult on the night following your procedure.
  • Get plenty of rest for the remainder of the day after your procedure. You may return to light activity the day after the procedure.
  • Avoid heavy lifting or strenuous labor for 3 days after your procedure.
  • Eat and drink normally. Increased fluid intake is recommended.
  • Mild pain, discomfort, or bruising at the procedure site is expected. You may take over-the-counter Tylenol for any pain you may experience.
  • You will have a small bandage over the site. You may remove the bandage in 3 days and leave the site dry and exposed. You may shower, but do not have a tub bath for 3 days.
  • Call your doctor if you have any of the following:
    • Signs of infection at the procedure site, such as redness, swelling, or a fever.
    • Coughing up blood
    • Bleeding from the procedure site.
    • Worsening, severe pain near the procedure site.
    • More than a small amount of fluid leakage from the puncture site.
    • Fainting or feeling lightheaded.
  • If you develop shortness of breath or chest pain that is not usual for you, return to the Emergency Department immediately.
  • If any further questions or complications arise and you do not know what to do, please call the radiology department at Summit Healthcare Regional Medical Center at (928) 537-4375, ext. 6549. For questions after hours please ask for ext. 6332.