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The skin of your chest is washed with antiseptic and Pleural Aspiration
a very fine needle is used to administer local anaesthetic. The local anaesthetic stings for a few Consumer Information
A small cut is made in the skin and a needle or thin plastic tube is inserted into the space between your lung and chest wall to remove the fluid. The doctor may use an ultrasound to see the inside of your Dr Stuart Lyon, Ms Ann Revell, Prof Grant Russell, chest on a screen, as this can help find where the Most frequently, this area is at the back of your What is a pleural aspiration?
chest or to the side. This is the reason why the A pleural aspiration is a procedure where a small doctor stands behind you while doing the pleural needle or tube is inserted into the space between aspiration. You may be asked to hold your breath by the lung and chest wall to remove fluid that has the doctor who is carrying out the procedure. accumulated around the lung. This space is called Depending on the amount of fluid removed, a tube may be left in place whilst the fluid drains out. Pleural aspiration is usually carried out to determine After the procedure, the small opening in the skin is why there is fluid around the lung (diagnostic procedure) or to improve symptoms (therapeutic procedure), as the fluid around the lung may be A chest X-ray is usually carried out 2–4 hours after causing symptoms such as cough, shortness of the procedure to assess for any complications. Complications are uncommon and are outlined in the ‘What are the risks of a pleural aspiration?’ section. How do I prepare for a pleural aspiration?
Do not eat or drink for 4 hours before the
Are there any after effects of a pleural
procedure. This is a routine precaution for many aspiration?
medical procedures. If you are diabetic, you should The area where the needle or tube has been inserted may feel a little tender for several days and You may need to stop medications that thin your there may be some bruising. If the area is painful, blood, as this may unnecessarily increase your risk simple pain relievers, such as paracetamol of bleeding. Examples include warfarin (often sold as Coumadin or Jantoven), clopidogrel (often sold as Your skin usually heals in a few days and you may Plavix), asasantin, heparin and enoxaparin sodium have a tiny scar (typically less than 5 mm) at the (often sold as Clexane). If you take any of these site where the needle or tube was inserted. medications or have any concerns about whether or not to stop taking them, please discuss this with How long does a pleural aspiration take?
your radiology practice before the procedure. The time taken for a pleural aspiration varies Bring all of your usual medication(s) (or a complete depending on how much fluid needs to be removed. list) with you when you attend for the procedure. It may take less than an hour or several hours. A Bring with you, if possible, relevant films or CDs chest X-ray is usually carried out 2–4 hours after the containing your previous imaging. This includes X- procedure and you will require medical supervision rays, ultrasounds, computed tomography (CT) scans until this occurs. This X-ray is carried out to check or magnetic resonance imaging (MRI). It is common for what is called a pneumothorax. A pneumothorax (but not essential) for people needing pleural is a leak of air into the space around the lung (see aspiration to have had a chest X-ray, chest What are the risks of a pleural aspiration?
Make arrangements with a relative or friend to drive There are some risks of a pleural aspiration that you should know about. Most of the more serious ones (pneumothorax, major bleeding from a large artery What happens during a pleural
or vein in the chest, or fluid accumulation in the aspiration?
lung) occur at the time of or very soon after the A pleural aspiration is carried out whilst you are procedure. This means they will be recognised while sitting upright on the side of a bed and leaning you are being observed in hospital or at the imaging forward. You will usually be provided with a place to rest your arms so you can lean over comfortably. A Quality Use of Diagnostic Imaging (QUDI) Initiative Immediate risks of the procedure include: Where is a pleural aspiration done?
Air around the lung (pneumothorax) and
A pleural aspiration is usually carried out in a collapse of the lung: When carrying out the
hospital or large medical centre, as you will require procedure, air may enter the space around the lung monitoring throughout the procedure in a setting via the drainage tube. Air may also leak from the where medical staff will be available to treat you in lung tissue itself. This is called a pneumothorax and can occur in up to 30% of cases. If this is a small leak you do not need treatment. If it is a bigger one When can I expect the results of my
you may need a chest tube and to stay in hospital. pleural aspiration?
Fluid build up in the lung: It is possible for fluid
If you are having fluid removed to relieve your to collect in your lung and make you short of breath, shortness of breath, you can expect significant relief particularly if a large amount of fluid is removed and your lung re-expands very quickly. This is an uncommon problem, but you may need to stay in If fluid is sent to a pathologist for further analysis, the time that it takes your doctor to receive a written report will vary depending on: Injury to your liver, spleen or heart: There is a
small risk of injury to your liver, spleen or heart.
• the urgency with which the result is needed This is a very rare complication, particularly if an • how the report is conveyed from the practice or ultrasound is used to assist with the procedure, but hospital to your doctor (in other words, email, After you are allowed to leave, seek medical Please feel free to ask the staff where you are attention urgently immediately if you notice any of having your procedure when your doctor is likely to the following, as they may suggest a serious complication that requires immediate treatment: It is important that you discuss the results with the • A lot of bleeding from the small cut in your skin. doctor who referred you, either in person or on the telephone, so that they can explain what the results Increasing shortness of breath. This may include leakage of air around the lung that needs Further information about pleural
New or worsening pain whilst breathing deeply. aspiration:
The results of a pleural aspiration are sometimes inconclusive. If this occurs, the aspiration may need Infection: There is a small risk of infection. If
to be repeated or alternative tests may be required. infection does occur, it is usually very minor and can be treated with antibiotics. What are the benefits of having a pleural
Please note:
A sample of the fluid that has been removed can be
This information is of a general nature only and is sent to a pathologist (a specialist doctor trained in not intended as a substitute for medical advice. It is analysing fluid) to determine why it has designed to support, not replace, the relationship that exists between a patient and his/her doctor. It is recommended that any specific questions A pleural aspiration can make you feel more regarding your procedure be discussed with your comfortable, as the fluid around your lung may be causing symptoms including shortness of breath, cough or chest pain. The InsideRadiology website is managed by the Who does the pleural aspiration?
RANZCR and funded by the Australian Government Many different types of doctors carry out pleural Department of Health and Ageing under the aspirations. It is commonly carried out by Publication Date: December 31st 2010
guidance is used, surgeons, physicians and general practitioners. The RANZCR is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might be possible to do so. It issues no invitation to any person to act or rely upon such opinions, advices or information or any of them and it accepts no responsibility for any of them. The RANZCR intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this publication may not be available at all radiology providers. The RANZCR recommends that any specific questions regarding any procedure be discussed with a person's family doctor or medical specialist. Whilst every effort is made to ensure the accuracy of the information contained in this publication, The RANZCR, its officers, councillors and employees assume no responsibility for its content, use, or interpretation. Each person should rely on their own inquires before making decisions that touch their own interests. A Quality Use of Diagnostic Imaging (QUDI) Initiative

Source: http://insideradiology.org.au/PDF/T91CPleural_Asp_CV.pdf

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