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Thoracentesis

What is a thoracentesis?

A thoracentesis is a procedure in which fluid is drained from the pleural space, which is a cavity that lies between the lung and chest wall. A variety of conditions including inflammation and infection can cause fluid to build up in this space.

About this Treatment Pre and Post Operative Care Departments

About this Treatment

How do we perform a thoracentesis?

First we will perform an ultrasound or CT scan to evaluate the amount and location of the fluid. Then the doctor will inject a local numbing medicine at the site where the fluid will be drained.

The doctor will guide a small needle through the skin and into the fluid, and the fluid will be sucked out (aspirated) with a syringe. If it is likely that fluid will continue to accumulate, the doctor will place a drainage catheter, using live X-ray (fluoroscopy) for guidance. Your child will be protected by an X-ray shield.

A small amount of chest fluid will be sent to the laboratory to determine the cause of the accumulation.

Will my child be awake during the procedure?

Younger patients are usually given IV sedation so they aren’t awake during the procedure. If the child is older or has medical problems that prevent us from giving IV sedation, we will only use local numbing medicine.

Will my child have pain after the procedure?

Your child will not feel pain during the procedure but some children feel pain or discomfort at the needle-insertion site, usually in the first day or two after the procedure. You may give over-the-counter pain medication for this.

How long does the procedure take?

Approximately 30 to 60 minutes.

What are the risks of chest drainage?

The procedure is considered low-risk. However, potential complications include:

Bleeding
Infection
Collapse of the lung (pneumothorax)
Bleeding into the chest (hemothorax)
Injury to surrounding structures such as veins or arteries

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

When can my child bathe?

We will place a bandage over the site. If your child doesn’t have a drainage catheter, you must keep the bandage dry and in place for 48 hours. Then you may remove the clear bandage and the gauze and your child can shower or take a bath as usual.

If a catheter was placed, the clear bandage and gauze must remain dry and in place until the catheter is removed. In addition, the catheter will be secured with a locking device (StatLock®), which must not be removed. You may sponge-bathe your child, as long as you keep the site dry.

Are there any activity restrictions?

If a drainage catheter was inserted, your child will need to avoid activities that may result in a pull to the catheter. Children who don’t have a drainage catheter may resume normal activity within two or three days.

CONTACT CNMC IMMEDIATELY IF YOUR CHILD EXPERIENCES ANY OF THE FOLLOWING:

• Redness, pain, swelling, or bruising at the needle insertion site.

• Fever higher than 101^o Fahrenheit or 38^o Celsius.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.

Departments

Interventional Radiology

Children’s National interventional radiologists perform a full range of minimally invasive, image-guided procedures to both diagnose and treat disease in infants, children, and adolescents.

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