Chest drainage

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.

The Procedure

An ultrasound or CT scan will be done 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 use only local numbing medicine. This procedure takes 30-60 minutes.

Risks

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

Pain

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.

Bathing after the procedure

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.

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.