How to Prepare for Pleurocentesis

Lungs are delicate organs surrounded by the chest wall. The thin space between the lungs and the chest wall—pleural space—protects and cushions the lungs. This pleural space contains a small amount of fluid that provides the cushioning effect.

However, excess fluid can sometimes build up in the pleural space leading to Pleural effusion. This can cause pain in the chest and difficulty in breathing.

Normally, your doctor may prescribe diuretics to resolve this condition. But, if the condition persists and leads to shortness of breath, your doctor may recommend pleurocentesis to remove the excess fluid and examine it.

What Is Pleurocentesis?

Pleurocentesis, also known as thoracentesis or pleural effusion treatment, is a minimally invasive procedure used to drain out the excess fluid from the pleural cavity for diagnosis or treatment.

Pleural Effusion|Source: Mesothelioma

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Pleural effusion is mainly caused by pneumonia, heart failure, pulmonary embolism and cancer.

Due to this excess fluid, your lungs are unable to inflate fully, making it difficult to breathe, especially with increased activity.

Pleurocentesis can help restore lung capacity and alleviate breathing difficulty.

In general, it involves using a long hollow needle that is carefully inserted into one of your lungs. The needle allows the medical professional to drain the excess fluid from your pleural cavity.

A person having pleurocentesis|Source: Wiki

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What Are the Benefits of Pleurocentesis?

Pleurocentesis is conducted to either diagnose the reason for pleural effusion or treat its symptoms (shortness of breath).

• It helps to relieve the pressure on the lungs due to fluid build-up.
• Relieves symptoms such as shortness of breath, cough and hypoxia.
• Helps to diagnose the reason for pleural effusion.
• Generally safe as it is ultrasound-guided.
• Requires local anesthesia.

How Do I Prepare for Pleurocentesis?

Pleurocentesis is a minimally invasive procedure. Your doctor will explain the details of the procedure and address all your concerns.

Let your doctor know:

• If you're under any medications or have any allergies.
• If you're pregnant or unsure about it.
• If you're on blood thinners.

Your doctor might ask you to stop all medications. Though it is a minimally invasive procedure, make sure to have a friend or family member drive you home.

You might also be asked to conduct additional tests such as X-ray, chest fluoroscopy, ultrasound or CT scan.

How Is Pleurocentesis Performed?

Pleurocentesis involves inserting a needle into the pleural space to withdraw the excess fluid. It is conducted under local anesthesia.

Before the procedure, you'll be asked to change into a surgical gown and remove your glasses, jewelry, and any other metal objects.

Usually, you'll be seated with your arms resting on a table in a position that allows your doctor to access the pleural fluid. If you're unable to sit, you might be asked to lay on your side.

You'll also be asked to stay still, exhale deeply and hold your breath in between the procedure.

Your doctor will mark the site of insertion on your back by determining the height of the effusion. The insertion is usually ultrasound-guided for accuracy and safety.

Your doctor will then clean the area with an antiseptic solution and administer local anesthesia.

A needle is inserted at the insertion site, which passes between your ribs and into the pleural space.

Once the needle reaches the pleural space, the pleural fluid is withdrawn and collected for diagnosis, and any excess fluid is drained out into a bottle or bag.

After the procedure, the needle is removed, and the insertion site is covered with a bandage.

Sometimes, a follow-up chest X-ray is taken to ensure there are no complications.

Pleurocentesis is a short procedure and takes only 10 to 15 minutes.

Care after the Pleurocentesis

Your healthcare provider will monitor your blood pressure, pulse and breathing. The insertion site will be checked to ensure there's no bleeding or fluid discharge.

Pleurocentesis is generally an outpatient procedure, so you can go home if everything is OK. You can resume your normal diet and regular activities, but you'll be advised to avoid strenuous exercise.

Once home, watch out for any of the following symptoms and inform your healthcare provider immediately.

• High Fever(above 100.40F) 
• Pain
• Swelling or redness at the site of insertion
• Shortness of breath
• Bleeding or fluid discharge at the site of insertion

What Are the Risks of Pleurocentesis?

Though pleurocentesis doesn't involve any incisions(cuts) and is comparatively safe, the procedure has certain risks.

The risks involved in pleurocentesis are:

• Pneumothorax—air in the pleural space causing the lung to collapse
• Bleeding
• Infection
• Injury to liver or spleen(very rare)

Pleurocentesis can't be performed in patients with severe respiratory diseases, low blood pressure, or can't sit still for the procedure.

When will I get the results of Pleurocentesis?

Once your doctor collects the pleural fluid, it is sent to the lab for testing.

You can expect the results within 1-2 working days, but if the test is done to check for tuberculosis, you might get the results in a few weeks.

The results will help your doctor diagnose the reason for pleural effusion and determine the next step of your treatment.

Conclusion

Pleurocentesis is a minimally invasive outpatient procedure. It is a safe and effective way to remove fluid from the chest. It relieves you of the pressure on your lungs and helps your doctor diagnose your condition. The procedure is usually well-tolerated and has a low risk of complications.