What is a Thoracentesis?
A thoracentesis is a minimally invasive procedure used to drain extra fluid around the lung. This can be done to help clinicians figure out why the fluid is there. It can also be done to make it easier and more comfortable to breathe.
How is a Thoracentesis done?
The clinician may use ultrasound to find the fluid. The clinician numbs the skin then places a tiny tube through the skin into the space around the lungs to drain the fluid. You may start coughing as the fluid drains off and your lungs expand. Afterwards, the tube is removed and a bandage applied.
Thoracentesis Procedure
1. The clinician may use ultrasound to find the fluid in the chest.
2. They numb the skin. They slide a tiny tube into the chest. The fluid drains out.
3. After, they remove the tube and put a bandage over the pinhole in the skin.
What are the risks?
A thoracentesis is safe when done by a specialist. In 1-3 in 100 cases, the lung may collapse slightly.
Full lung collapse is very rare and can require a chest tube to expand the lung.
Bleeding occurs in 1-3 of 100 cases.
Infection or damage to other organs are extremely rare.
What are the alternatives?
Alternative 1 Not doing the thoracentesis. This can be an option if there is no concern that the fluid is infected. However, the fluid could come back. If it is infected, there could be a delay in starting the right treatment.
The next 3 alternatives are for people whose fluid keeps coming back:
Alternative 2 Tunneled drainage catheter. This longer-term tube is placed in your chest to allow you to drain the fluid into special containers at home.
Alternative 3 Denver shunt. This longer-term tube has a small pump beneath the skin to draw the fluid from the chest and return it to the blood through a vein in the neck.
Alternative 4 TIPS. This is a treatment for high blood pressure in the liver, which is one cause of fluid in the chest. A little tube allows some of the blood to bypass the liver. This can reduce the build-up of fluid around the lungs. The risks with TIPS are higher than the other options.