Are you having difficulty breathing and feeling a tightness in your chest? Sometimes this can be caused by an unnecessary accumulation of fluid around your lungs. In medical terms, we call this condition `(pleural effusion)`. So today we are going to talk about a simple, yet very important treatment for this.
What is Thoracentesis?
To put it simply, think of it this way. To make a door latch work properly and not get stuck, we put some oil in it, right? Similarly, when we breathe, there is a small amount of fluid in the space between the lungs and the chest wall, called the ``pleural space``, so that our lungs do not stick to the walls of the chest and can easily expand and contract.
However, due to some diseases, this fluid can accumulate in excess. Then the lungs do not have enough space to inflate properly and it becomes difficult to breathe. At that time, using a needle-like instrument, inserted into the chest from the back and removing this excess fluid is called `(Thoracentesis)`.
Is this a major surgery?
No, not at all. This is not a major surgery. This is a ``minimally invasive`` procedure, which means that no major incision is made. Only a small hole is made in the skin. Therefore, the recovery time is short and the risks are very low.
For what reasons is a thoracentesis performed?
This treatment is done for two main reasons: one is to diagnose the disease, and the other is to provide relief from symptoms.
| Reason for treatment | Description |
|---|---|
| For diagnosis | Find the cause of the fluid buildup around the lungs. A sample of the fluid removed in this way can be sent to a lab to determine if it contains an infection, cancer cells, or another problem. |
| To reduce symptoms | If you have difficulty breathing because of a lot of fluid buildup or feel a heaviness in your chest, some of this fluid can be removed to reduce the discomfort. You will feel great relief. |
Simply put, this can help both diagnose the illness and reduce the discomfort caused by it.
What causes water to fill around the lungs like this?
Thoracentesis is used to treat a condition called pleural effusion. However, there are a number of underlying conditions that can cause this condition. Some of them include:
- Congestive heart failure
- Cancer
- Pneumonia or other lung infections (bacterial, viral)
- Autoimmune diseases such as lupus (Lupus/SLE)
- Blood clot in the lungs (pulmonary embolism)
- Some high blood pressure conditions (pulmonary hypertension)
- Inflammation of the pancreas (pancreatitis)
- Kidney or liver disease
- Tuberculosis (TB)
The most common of these is fluid accumulation around the lungs due to heart conditions.
How can you prepare for this in advance?
Okay, now let's say the doctor tells you to have this treatment. So what should you do? The doctor will give you some specific instructions. And you should also inform the doctor about these things.
- Tell your doctor about all the medications you are taking: This is especially important if you are taking blood thinners .
- Tell us if you have a bleeding disorder: It is very important to let us know if you have a problem that prevents your blood from clotting easily.
- Tell us if you are pregnant or suspect you are.
- Tell us if you have any allergies to any medications, plasters, or latex.
- You may also be asked to bring someone to take you home after treatment.
What happens during a thoracentesis?
This is usually done in a hospital, and the entire procedure takes about 15 minutes. You are awake during this time.
Before treatment
Your blood pressure and oxygen levels will be checked. An X-ray, ultrasound, or CT scan will be used to determine the exact location and amount of fluid. You will then be asked to sit on a table with your hands on the table and lean forward. This is the easiest position. If you can't do this, you will be asked to lie on your side.
During treatment
1. First, the area where the needle will be inserted on your back will be thoroughly cleaned with an antiseptic solution.
2. Then a numbing medicine is injected into the area. It feels like a small ant is biting you, but then the area goes numb and you don't feel any pain.
3. Once the area is numb, the doctor will make a small incision, insert a needle between the ribs, and remove the excess fluid into a syringe or a tube into a bottle. The needle may be inserted using an ultrasound scan.
4. You may feel a little pressure or discomfort when the fluid is removed, but it should not be painful. If you experience chest pain or difficulty breathing, tell your doctor immediately.
5. After the required amount of liquid is taken, the needle is removed and a small band-aid is applied.
After treatment
After the treatment, you may have another X-ray to check if your lungs are healthy. If your condition is good, you can go home in a short time. You may have a cough for about an hour after the treatment. This is normal, don't worry. This is because your lungs are getting better at expanding again.
What are the benefits and risks of this?
Like any medical treatment, this has benefits and very small risks.
| Advantages | Risks |
|---|---|
| These are very rare things:
|
How long does it take to heal and when should you see a doctor?
It doesn't take long to heal. Your doctor will tell you to avoid strenuous activity for about two days. You can remove the bandage after 24 hours.
However, if you experience any of the symptoms below, do not delay and see your doctor immediately. Or go to the Emergency Department (ETU) of the nearest hospital.
- Fever.
- Redness, swelling, or bleeding where the needle was inserted.
- Chest pain or pain when taking a deep breath.
- Coughing up blood (hemoptysis).
- Sudden difficulty breathing.
Take-Home Message
- Thoracentesis is a simple, safe procedure that removes excess fluid that accumulates around the lungs.
- This is not a major surgery, it only takes about 15 minutes.
- This provides immediate relief from shortness of breath and helps to identify the cause of the fluid buildup.
- Be sure to tell your doctor about the medications you are taking and your medical conditions before treatment.
- If you develop fever, chest pain, or severe cough after treatment, seek medical advice immediately.
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