What is thoracentesis?

Thoracentesis is a procedure to remove fluid from the space between the lungs and the chest wall called the pleural space. It is done with a needle (and sometimes a plastic catheter) inserted through the chest wall. Ultrasound pictures are often used to guide the placement of the needle. This pleural fluid may be sent to a lab to determine what may be causing the fluid to build up in the pleural space.

Normally only a small amount of pleural fluid is present in the pleural space. A buildup of excess pleural fluid (pleural effusion) may be caused by many conditions, such as infection, inflammation, heart failure, or cancer. If a large amount of fluid is present, it may be hard to breathe. Fluid inside the pleural space may be found during a physical examination and is usually confirmed by a chest X-ray.

Activity

• Have your child rest when your child feels tired.
• Allow your child's body to heal. Don't let your child move quickly or lift anything heavy until your child is feeling better.
• Your child may shower. Your child should not swim or take a bath until the puncture site has healed, or until the doctor tells you it is okay.
• Many children are able to return to normal activities within 1 or 2 days after the procedure.

Diet

• Your child can eat a normal diet.
• Your child should drink plenty of fluids (unless your doctor tells your child not to).

Medicines

• Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
• If your child stopped taking aspirin or some other blood thinner, your doctor will tell you when to have your child start taking it again.
• Be safe with medicines. Read and follow all instructions on the label.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • Store your child's prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, give them as directed. Do not stop giving them just because your child feels better. Your child needs to take the full course of antibiotics.

Care of the puncture site

• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing. You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

This procedure takes about 10 to 15 minutes.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Thoracentesis is generally a safe procedure. A chest X-ray may be done right after the procedure to make sure that no complications have occurred. Complications may include:

• A partial collapse of the lung (pneumothorax).
• Fluid buildup in the lung.
• Infection.
• Bleeding.
• Damage to another organ, such as the liver or spleen.

When you are given the shot to numb your skin at the needle site, you will feel a sharp stinging or burning sensation that lasts a few seconds. When the needle is inserted into the chest wall, you may again feel a sharp pain for a few seconds.

When the pleural fluid is removed, you may feel a sense of "pulling" or pressure in your chest. Tell your doctor or nurse if you feel faint or if you have any shortness of breath, chest pain, or uncontrollable cough.

Thoracentesis (say "thor-uh-sen-TEE-sis") is a procedure to remove fluid from the space between the lungs and the chest wall (pleural space). This procedure may also be called a "chest tap." It's normal to have a small amount of fluid in the pleural space. But too much fluid can build up because of problems such as infection, heart failure, or lung cancer. The procedure may have been done to help with shortness of breath and pain caused by the fluid buildup. Or you may have had this procedure so the doctor could test the fluid to find the cause of the buildup.

Your chest may be sore where the doctor put the needle or catheter into your skin (the puncture site). This usually gets better after a day or two. You can go back to work or your normal activities as soon as you feel up to it.

If a large amount of pleural fluid was removed during the procedure, you will probably be able to breathe more easily.

If more pleural fluid collects and needs to be removed, another thoracentesis may be done later.

Thoracentesis may be done to:

• Find the cause of excess pleural fluid (pleural effusion).
• Relieve shortness of breath and pain caused by a pleural effusion.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the procedure may be canceled. If your doctor told you to have your child take any medicines on the day of the procedure, have your child take them with only a sip of water.
• Follow the doctor's instructions about when your child should bathe or shower before the procedure. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Your child should not wear contact lenses. Have your child's glasses or contact lens case with you for after the procedure.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• The doctor may take a chest X-ray or use ultrasound or CT scan pictures to help find the exact spot where fluid has built up.
• Your child will be kept comfortable and safe by the anesthesia provider. The anesthesia may make your child sleep. Or it may just numb the area being worked on.
• The procedure will take about 15 minutes.
• You will probably be able to take your child home or to the hospital room after the procedure.