Thoracentesis

Thoracentesis
-is a diagnostic procedure in which a needle is inserted through the back of the chest wall into the pleural space (a space that exists between the two lungs and the interior chest wall) to remove fluid or air. Pleural fluid analysis is the microscopic and chemical lab analysis of the fluid obtained during thoracentesis.

Indications
Pleural effusion Hemothorax Diagnostic studies
- Gram stain Culture - sensitivity - acid-fast staining and culture - differential cell count - lactic dehydrogenase

Contraindications

Uncorrected bleeding diathesis Chest wall cellulitis at the site of puncture Skin infection or zoster overlying area to be needled. Severe Coagulopathy

Equipments

Procedure

Interpreting Results of Thoracentesis. EXAMINING PLEURAL FLUID

Characteristic Light, straw colored Purulent Possible Cause Empyema

Blood Tinged

Milky

Hemothorax Tuberculosis Pulmonary Infarction Neoplastic Disease Accidental tissue damage from thoracentesis Chylothorax Invasion of thoracic duct by a tumor, or an inflammatory process Traumatic rupture of thoracic duct Cellular debris or cholesterol crystals Cirrhosis Congestive Heart failure

Low protein fluid

Complications Pneumothorax Hemopneumothorax Hemorrhage Hypotension due to a vasovagal response Pulmonary edema due to lung re expansion Spleen or liver puncture Air embolism Introduction of infection