Pleural paracentesis

INTRODUCTION

Pleural paracentesis, also known as a pleural tap and thoracentesis, is a procedure performed to
remove excess fluid or air from your pleural space.

The pleural space is the small space between your lungs and your chest wall. A buildup of fluid
in your pleural space is called pleural effusion. Pleural effusion can compress your lungs and
cause difficulty breathing.

Some conditions that can cause pleural effusion include:

 cancerous tumors

 pneumonia or other lung infections

 congestive heart failure

 liver failure known as cirrhosis

DEFINITION

Pleural paracentesis is a minimally invasive procedure that involves inserting a needle into the
pleural space around your lungs. The goal is to drain fluid or air in order to make it easier for you
to breathe. In some cases, the procedure will also help your doctor discover the cause of your
fluid buildup.

The amount of fluid your doctor drains depends on the underlying condition you’re dealing with.
The National Heart, Lung, and Blood InstituteTrusted Source says that it typically takes 10 to 15
minutes, but it can take longer if there’s a lot of fluid in your pleural space. After thoracentesis, a
lab test called a pleural fluid analysis may be performed to figure out the cause of fluid
accumulation around one or both of your lungs.

Your doctor may also perform a pleural biopsy. Though not commonly performed, it can help
identify the underlying cause of pleural effusion. Potential causes include:
  the presence of cancer cells, such as lung cancer

 mesothelioma, which is an asbestos-related cancer of the tissues that cover your lungs

 pleural tuberculosis

PROCEDURE

Pleural paracentesis can be done in a doctor’s office or in a hospital. It’s typically performed
while you’re awake, but you may be sedated. You’ll need someone else to help you get home
after the procedure if you’re sedated.

1. After sitting in a chair or lying on a table, you’ll be positioned in a way that allows your
doctor to access your pleural space.

2. Your doctor should use an ultrasound to confirm the correct area where the needle will
go. In some cases, they may also use CT guidance.

3. The selected area will be cleaned and injected with a numbing agent.

4. Your doctor will insert the needle or tube between your ribs into your pleural space. You
might feel an uncomfortable pressure during this process, but try to keep very still. The
excess fluid will then be drained out.

5. Once all the fluid is drained, a bandage will be put on the insertion site.

6. Your doctor may perform a follow-up X-ray right after the plural paracentesis.

7. Depending on the severity of your symptoms and to ensure there are no complications,
they may ask you to stay overnight in the hospital or clinic to be monitored.

INDICATIONS

Pleural paracentesis is performed in people with pleural effusion to either improve breathing or
help make a diagnosis. The American Thoracic Society says that the most common reasons to
perform. Pleural paracentesis are:

 to diagnose the cause of new pleural effusion

 to diagnose cancer or improve cancer symptoms

 to diagnose a suspected infection

Your doctor can determine whether you’re a good candidate for Pleural paracentesis.

Some people may not be able to safely undergo Pleural paracentesis. You might not be a good
candidate for Pleural paracentesis if you have insufficient pleural fluid or a skin infection or
wound at the needle insertion site.

Doctors are also cautious to perform Pleural paracentesis on people who:

 can’t be safely repositioned

 have bleeding disorders

 are taking blood thinners

 may have scarring from recent lung surgery

 have other conditions where potential complications outweigh benefits

PREPARATIONS

There’s no special preparation for a Pleural paracentesis. However, speak with your doctor if you
have any questions or concerns about the procedure. Also, tell your doctor if you:

 are currently taking medications, including blood thinners like aspirin, clopidogrel
(Plavix), or warfarin (Coumadin)

 are allergic to any medications

 have any bleeding problems

 may be pregnant

 have lung scarring from previous procedures

 currently have any lung diseases like asthma or emphysema

Every invasive procedure has risks, but side effects are uncommon with Pleural paracentesis.
Possible risks include:

 pain

 bleeding

 bruising

 air accumulation (pneumothorax) pushing on the lung, causing a collapsed lung

 infection

Liver or spleen injuries are also potential complications, according to the National Heart, Blood,
and Lung Institute Trusted Source, but they’re rare nowadays because of the use of ultrasound
and CT scans.

AFTER PROCEDURE

After the procedure is over, your doctor will monitor your vitals and may order an X-ray of your
lungs. They will allow you to go home if your breathing rate, oxygen saturation, blood pressure,
and pulse are all good. Most people who have a Pleural paracentesis can go home the same day.

You’ll be able to return to most of your usual activities soon after the procedure. However, your
doctor may recommend that you avoid physical activity for several days.

Your doctor will explain how to take care of the puncture site. Make sure to contact 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