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Thoracentesis / ˌ θ ɔː r ə s ɪ n ˈ t iː s ɪ s /, also known as thoracocentesis (from Greek θώραξ (thōrax, GEN thōrakos) 'chest, thorax' and κέντησις (kentēsis) 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic ...
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
The fluid is a transudate and similar to fluid found in ascites. [4] There may be a higher protein and albumin content in hepatic hydrothorax due to the pleura absorbing the water. [ 5 ] To rule out heart-related causes of pleural effusion, an echocardiogram can be performed.
Excess fluid from the pleural space is drained into a bag. Once the presence of an excess fluid in the pleural cavity, or pleural effusion, is suspected and location of fluid is confirmed, a sample of fluid can be removed for testing. [14] The procedure to remove fluid in the chest is called a diagnostic thoracentesis. [15]
Pleural fluid sample from a hemothorax taken by thoracentesis Although imaging techniques can demonstrate that fluid is present within the pleural space, it may be unclear what this fluid represents. To establish the nature of the fluid, a sample can be removed by inserting a needle into the pleural cavity in a procedure known as a ...
Chest x-ray is the first test done to confirm an excess of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL.
Data from a meta-analysis has shown that a pleural fluid pH of <7.2 is the most powerful indicator to predict the need for chest tube drainage in patients with non-purulent, culture negative fluid. [ 16 ]
On the surface of this solution, 1 drop of the effusion fluid is carefully layered. If the drop disappears and the solution remains clear, the Rivalta's test is defined as negative. If the drop retains its shape, stays attached to the surface or slowly floats down to the bottom of the tube (drop- or jelly-fish-like), the Rivalta's test is ...