Ultrasound Guided Aspirations

Pleural aspiration is a procedure that involves the insertion of a needle into the pleural space to obtain the fluid or tissue sample. The procedure is usually performed under imaging guidance (ultrasound-guided) to guide the needle precisely to the abnormal tissue site. Pleural aspiration is both a diagnostic and therapeutic procedure. It helps in diagnosing the disease by evaluating the sample in the laboratory. It also relieves the symptoms, such as chest pain, cough, and shortness of breath, by draining the fluid from the pleural space.

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  • Preparation for Pleural Aspiration: The interventional pulmonologist provides all the instructions in detail related to preparing for the pleural aspiration. The patients are advised not to eat or drink for at least 4-6 hours before the procedure. However, diabetic patients should specifically consult with their doctors before fasting. The patients should also avoid taking medications that increase their risk of bleeding, such as NSAIDs or aspirin. The patients are also advised to carry their prior imaging reports with them for comparison.
  • Technique for Pleural Aspiration: The skin of the chest is cleaned with disinfectant before the pleural aspiration. A local anesthetic agent is applied. The patients may initially have a stingy sensation before the feeling of numbness. The surgeon cuts the chest skin and inserts a fine needle under ultrasound guidance. The images from the ultrasound assist the surgeon in detecting the area of maximum fluid accumulation. The patients are advised to hold their breath intermittently during the procedure. After the aspiration, the incision is closed with sutures and a dressing.
  • Complications of Pleural Aspiration: Some complications of pleural aspiration are infection, bleeding, pain, swelling, pus formation, discharge, lung collapse, and injury to the spleen or liver (rare in ultrasound-guided pleural aspiration).