Thoracentesis PDF

American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
Thoracentesis
Thoracentesis (thor-a-sen-tee-sis) is a procedure that is
done to remove a sample of fluid from around the lung.
The lung is covered with a tissue called the pleura. The
inside of the chest is also lined with pleura. The space
between these two areas is called the pleural space. This
space normally contains just a thin layer of fluid, however,
some conditions such as pneumonia, some types of
cancer, or congestive heart failure may cause excessive
fluid to develop (pleural effusion).
To remove this fluid for evaluation (testing) or to ■■ Cancer—Some cancers spread to the lung or
reduce the amount of fluid, a procedure called a the pleura (the lining of the lung and chest wall).
thoracentesis is done. This can cause fluid to build up in the chest.
CLIP AND COPY
Thoracentesis involves placing a thin needle or tube A thoracentesis may be done to help make a
into the pleural space to remove some of the fluid. diagnosis. Fluid that is drained can be examined
The needle or tube is inserted through the skin, in the laboratory to see if cancer cells are present.
between the ribs and into the chest. This proce- This type of pleural effusion is called a Malignant
dure may be done to remove fluid for testing or for Pleural Effusion (MPE). For more information on
treatment. The needle or tube is removed when the MPE see the ATS Patient Information Series piece
procedure is completed. If a person needs more fluid “Malignant Pleural Effusion at www.thoracic.org/
drained, sometimes the tube is left in place for a patients)
longer time (see Patient Information Series on Chest ■■ Comfort—A large build up of fluid can be painful
Tube Thoracostomy at www.thoracic.org/patients). and make it hard to breathe. Removing some fluid
may make the person more comfortable.
Why Do I Need a Thoracentesis?
The most common reasons for doing a What are the Risks of a Thoracentesis?
thoracentesis are: Risks of having a thoracentesis are not common and
■■ New pleural effusion—Thoracentesis may be are usually not serious. Your doctor will explain the
done to figure out the cause of new fluid build-up risks and how likely they may be for you when you
in the chest. give consent for the procedure. Some of the possi-
■■ Infection—When an infection is suspected ble risks of thoracentesis include:
to be the cause of fluid build-up in the chest, ■■ Pain during placement—Discomfort can result
a thoracentesis may be done to help make a from the needle at the time it is inserted. Doctors
diagnosis. Fluid that is drained can be analyzed try to lessen any pain or discomfort by giving a
in the laboratory to identify the type of germ local numbing medicine (topical anesthetic). The
causing the infection and what medicines discomfort is usually mild and goes away once the
(antibiotics) might be effective. needle or tube is removed.
Am J Respir Crit Care Med Vol. 176, P1-P2, 2007

Online Version Updated February, 2016
ATS Patient Education Series © 2016 American Thoracic Society
www.thoracic.org
American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
■■ Bleeding—During insertion of the needle, a blood Often this procedure is done as an outpatient,
vessel in the skin or chest wall may be accidentally though your health care provider may have you stay
nicked. Bleeding is usually minor and stops on in the hospital for a day for observation.
its own. Sometimes, bleeding can cause a bruise
Authors: MM Sockrider MD, DrPH; Suzanne Lareau, RN;
on the chest wall. Rarely, bleeding can occur into C. Manthous MD
or around the lung and may require a chest tube Reviewers: A. Barker, B. Fahy, P. Mathur, J. Reardon.
or surgery. (See Patient Information Series on
Chest Tube Thoracostomy at www.thoracic.org/ Adapted from: ATS Critical Care Assembly: A Primer on Critical
Care for Patients and Their Families
patients).
Collapsed lung—When the needle is being placed,
R Action Steps
■■
it may puncture the lung. This hole may seal

quickly on its own. If the hole does not seal over,
✔✔ Talk to your doctor about why the procedure is needed and
air can leak out and build up around the lung. how much fluid is expected to be drained.
This build-up of air can cause part or all of the ✔✔ Ask your doctor about the use of numbing medicine (anesthet-
lung on that side to collapse (pneumothorax). If ic) or medicine that causes sleepiness (sedative) before the
procedure.
this happens, the doctor can place a chest tube
✔✔ Ask how to take care of the wound after the procedure.
between the ribs into the chest to remove the ✔✔ Call your doctor is you have:
air that is leaking from the lung (See ATS Patient • Bleeding from the needle site
Information Series on Chest Tube Thoracostomy • New, sudden difficulty breathing
at www.thoracic.org/patients). • Pain taking a deep breath
• A cough that produces blood
Getting ready for a Thoracentesis Healthcare Provider’s Contact Number:
Your physician or other member of the health care
team will provide you with instructions about how
you will need to prepare for the procedure, including
taking medications prior to or the day of the proce- Additional Information:
dure, following a specific diet, and so forth. ATS Patient Information Series
Usually an imaging test is done to look at how much www.thoracic.org/patients
fluid is around the lungs. This may be a chest radio- National Heart Lung and Blood Institute
http://www.nhlbi.nih.gov/health/health-topics/topics/thor/
graph (x-ray), a chest ultrasound, and/or a chest CT
US National Library of Medicine
(“cat-scan”) to look at where the pleural fluid is and https://www.nlm.nih.gov/medlineplus/ency/article/003420.htm
how much is there. Sometimes the procedure is
done using ultrasound guidance. This information is a public service of the American Thoracic Society.
The content is for educational purposes only. It should not be used as a
Usually an adult or older child remains awake when substitute for the medical advice of one’s health care provider.
a thoracentesis is done. Sometimes a person, partic-
ularly a younger child, is given medicine (a sedative)
that causes sleepiness before a the procedure. The
skin is cleaned with a disinfectant before the needle
is inserted. Sometimes a local numbing medicine
(anesthetic) is injected into the skin first. The fluid
may drain through the needle or the doctor may
slide a small plastic tube through the needle to drain
fluid. When the fluid is removed, the needle and
tube are removed and a bandage is placed over the
insertion site wound. The wound closes on its own
without the need for stitches.
www.thoracic.org

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American Thoracic Society

PATIENT EDUCATION | INFORMATION SERIES

Am J Respir Crit Care Med Vol. 176, P1-P2, 2007

PATIENT EDUCATION | INFORMATION SERIES

it may puncture the lung. This hole may seal

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