Pulmonary - Critical Care Associates
of East Texas

Jeffrey M. Shea, M.D., F.C.C.P.
                              Venkatesh Donty, M.D.

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Purpose

To remove fluid or air from the chest. This space usually contains a very small amount of fluid to help lubricate the lining between the lung and chest wall. Generally a thoracentesis is done to determine why an abnormal amount of fluid has collected, and also to help relieve the symptoms of shortness of breath when the fluid is causing compression of the normal lung.

Technique

Removal of fluid is done with the patient in a sitting position. A needle is inserted one or two rib spaces below the area of the fluid. The skin, rib periosteum (fibrous membrane which forms the covering of bone), and parietal pleura (membrane that lines the chest wall), which are the only pain-sensitive structures in the chest wall, are anesthetized with local anesthetic. A thoracentesis needle (on a syringe) is advanced into the pleural space and a tube is inserted into the fluid between the chest wall and lung. The fluid is removed manually using a two way stop-cock, or with a vacuum bottle. This should be a painless procedure, although some may have some discomfort around their shoulder blades.

                                                Thoracentesis

 

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