(Pleural Fluid Aspiration; Pleural Tap)
A pleural effusion is a build-up of fluid in the space between the lungs and the chest wall. This space is called the pleural space. Thoracentesis is a procedure to remove fluid from this area.
There are two types of thoracentesis:
- Therapeutic thoracentesis—to relieve the symptoms of fluid accumulation
- Diagnostic thoracentesis—to test for the cause of the fluid build-up
Reasons for Procedure
There is always a small amount of fluid in the pleural space. The fluid helps to lubricate the area. When too much fluid builds up in this space, it can make it difficult to breathe.
Your doctor may want to test some of the fluid after removing it. The build-up of fluid can be a symptom of diseases or disorders, such as:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Collapsed lung
- Fluid building up again
- Damage to the lung, liver or spleen
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor may order:
Description of the Procedure
You may be asked to sit upright on the edge of a bed or chair. Your arms will be resting on a nearby table. If your procedure involves a CT scan, you may be asked to lie on a table. Try to avoid coughing, breathing deeply, or moving during the procedure.
A small patch of skin on your back, chest, or under your armpit will be sterilized. Anesthesia will be applied to this patch. It will help numb the area.
The doctor may use ultrasound or CT scan images to guide the needle and monitor the fluid. A needle or thin plastic catheter will be inserted between your ribs. The needle or catheter is then passed into the pleural space. Some or all of the fluid will be drawn into the syringe.
Placement of Thoracentesis Needle
Will It Hurt?
You may feel slight pain or a stinging when the needle is first inserted. As the fluid is being extracted, you may feel a sense of pulling. Tell your healthcare team if you feel extreme pain, any shortness of breath, or faint.
At the Care Center
If the thoracentesis is being done for diagnostic reasons, the fluid will be sent to a lab for testing. Often, another chest x-ray will be done to ensure that the fluid has been removed and that there is no sign of a collapsed lung.
The doctor may begin treatment for the cause of the fluid build-up.
Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the insertion site
- Pain that you cannot control with the medicatons you've been given
- Cough, shortness of breath, or chest pain
- Coughing up blood
- Pain when taking a deep breath
If you think you have an emergency, call for medical help right away.
American Lung Association
American Thoracic Society
The Canadian Institutes of Health Information
The Lung Association
Explore thoracentesis? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/thor. Updated February 24, 2012. Accessed February 18, 2015.
Harrison’s Principles of Internal Medicine. 16th ed. McGraw-Hill; 2005.
Mason RJ. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. WB Saunders; 2005.
Roberts JR. Clinical Procedures in Emergency Medicine. 4th ed. WB Saunders; 2004.
Thoracentesis. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/pulmonary/thoracentesis_92,P07761. Accessed February 18, 2015.
Thoracentesis. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/pulmonary_disorders/diagnostic_pulmonary_procedures/thoracentesis.html. Updated September 2013. Accessed February 18, 2015.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed : Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.