User:Mr. Ibrahem/Thoracentesis

Thoracentesis is a medical procedure to remove fluid from the pleural space for diagnostic or treatment purposes. For diagnosis it is indicated if the cause is unclear and more than 1 centimeter of fluid is present. For treatment it is done to improve shortness of breath. If the fluid reoccurs despite multiple drainages a long term catheter may be placed or pleurodesis may be carried out.

The procedure is typically done with the person sitting and leaning over a table. The location can be verified with ultrasonography at the bedside. The area is cleaned with chlorhexidine and local anesthetic is injected. A hollow needle is than inserted just above a rib at the scapular line. The needle is slowly advanced until fluid is aspirated, after which the catheter is slide into the chest and the needle withdrawn. A collection container may than be attached.

Complications may include pneumothorax, bleeding, low blood pressure, and injury to the spleen or liver. Previously, only about 1.5 liters of fluid would be removed due to the concern of increased risks of reexpansion pulmonary edema with greater volumes. This concern; however, appears to be unfounded and all the fluid present can likely be safely drained. Coughing normally occurs as the lung reexpands.

Thoracentesis was first performed in 1850 by Morrill Wyman and Henry Ingersoll Bowditch. In the United States the procedure can cost about 2,000 USD. The technique had been proposed earlier by Hippocrates in 400 BC. The term is from Greek θώραξ thōrax meaning "chest" and κέντησις kentēsis meaning "puncture".