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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 ...
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.
Diagnosis involves extracting the fluid via thoracentesis; after this, the fluid is analyzed to diagnose and rule out other causes. [7] The fluid can be analyzed for serum, protein, albumin, lactate dehydrogenase, and cell count. The fluid is a transudate and similar to fluid found in ascites. [4]
Hematocrit can be roughly calculated by dividing the red blood cell count of the pleural fluid by 100,000. [6] Thoracentesis is the test most commonly used to diagnose a hemothorax in animals. [28] Hemothorax can itself be a rare complication of thoracentesis if the intercostal artery is punctured. [29]
The free end of the tube is usually attached to an underwater seal, below the level of the chest. This allows the air or fluid to escape from the pleural space, and prevents anything returning to the chest. Alternatively, the tube can be attached to a flutter valve. This allows patients with pneumothorax to remain more mobile. [20]
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]
Image shows early occurrence of tracheal deviation. Tracheal deviation is a clinical sign that results from unequal intrathoracic pressure within the chest cavity.It is most commonly associated with traumatic pneumothorax, but can be caused by a number of both acute and chronic health issues, such as pneumonectomy, atelectasis, pleural effusion, fibrothorax (pleural fibrosis), or some cancers ...