Fluid Aspiration (Paracentesis/Thoracentesis)
What is chest drainage (thoracentesis)?
Chest drainage is a procedure to drain fluid from the pleural space, between the lung and chest wall. Inflammation, infection and traumatic injury, among other things, can cause fluid to build up in the cavity.
How is chest drainage performed?
First we will give your child 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 children are usually given IV sedation so they aren’t awake during the procedure. If your child is older or has medical problems that prevent us from giving IV sedation, we will use only local numbing medicine.
How long does the procedure take?
The procedure lasts 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
Will my child have pain after the procedure?
Some children feel pain or discomfort at the needle-insertion site, usually in the first day or two after the procedure. You may give your child over-the-counter pain medication.
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. After that, you may remove the bandage and 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 could pull at the catheter. Children who don’t have a drainage catheter may resume normal activity within two or three days.