Pleural puncture is most often a diagnostic puncture of the pleural cavity. As a rule, fluid accumulates in it during various diseases, for example, with a lung tumor, with cardiac edema, with tuberculosis or pleurisy. This fact is the basis for pleural puncture. The fluid level in the cavity is determined by percussion, by x-ray or by ultrasound examination of the pleural cavity. Pleural empyema, pleurisy , intrapleural bleeding and transudate in the pleural cavity are also direct indications for the procedure.
Pleural puncture. Technique
Diagnostic pleural puncture is performed in the dressing room or in the patient’s room. The patient is given local anesthesia with novocaine, during the procedure the patient takes a sitting position with his hands laid back. Any diagnostic puncture most often ends with therapeutic measures, namely the complete removal of pathological contents from the cavity, washing with an antiseptic and the introduction of antibacterial drugs into the cavity. In the case of hemothorax, drainage is carried out with a system for harvesting autologous blood. The first portion of the contents from the pleural cavity is evaluated visually by the doctor, to obtain complete more comprehensive information, the contents are sent for cytological, biochemical and bacterial studies.
Pleural puncture. Possible complications
The procedure requires special skills from the doctor, and yet, even with a competent approach, the patient may experience various complications during the manipulation process. This can be a sharp displacement of the mediastinum, tachycardia, collapse. In order to avoid such phenomena, the doctor should carefully monitor the patient's condition and squeeze the tube with a clamp during pleural puncture.
What is the purpose of pleural puncture?
In the pleural cavity of any healthy person is constantly approximately 50 ml of fluid. Diseases of the lungs and pleura can lead to the fact that between the leaves of the pleura edematous or inflammatory fluid accumulates. Since it greatly worsens the condition of the patient, it is removed with pleural puncture. If there is not much liquid, then the patient is given a diagnostic puncture, it helps to determine the presence of pathological cells and determine the nature of the accumulated liquid.
Preparation for pleural puncture
The pleural puncture set includes a twenty-gram syringe, a needle 7-10 cm long and 1 - 1.2 mm in diameter and with a sharp beveled tip, it is attached to the syringe with a rubber tube. To prevent air from entering the pleural cavity during the procedure, a special clip is applied to it. A set of two or three tubes will be required to send the exudate for examination, in addition to them, you must have a sterile tray with tweezers, tampons, cotton swabs, as well as alcohol, iodine, collodion and ammonia in case of a patient fainting.
Pleural puncture with pneumothorax
Spontaneous pneumothorax is also a direct indication for pleural puncture. The technique of this manipulation is no different from the usual, except that with pneumothorax from pleural puncture, air is sucked out with a syringe or pleuroaspirator. With the development of valvular pneumothorax, air during inspiration constantly enters the pleural cavity. Since there is no reverse drainage, the clamp is not applied to the tube after the puncture, but air drainage is left. Do not forget that after pleural puncture the patient should be urgently hospitalized in the surgical department.