Why do we need a pleural puncture?

Pleural puncture is most often a diagnostic puncture of the pleural cavity. As a rule, it accumulates fluid in various diseases, for example, with a lung tumor, with cardiac edema, with tuberculosis or pleurisy. This fact is the basis for pleural puncture. The level of fluid in the cavity is determined by percussion, radiography or ultrasound examination of the pleural cavity. An empyema of the pleura, pleurisy , intrapleural bleeding and a transudate in the pleural cavity are also direct indications for the procedure.

Pleural puncture. Techniques for conducting

Diagnostic pleural puncture is performed in the dressing room or in the patient's ward. The patient is given local anesthesia with novocaine, during the procedure the patient assumes a sitting position with the arms withdrawn back. Any diagnostic puncture is most often completed by therapeutic measures, namely the complete removal of pathological contents from the cavity, washing with an antiseptic and introducing 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 by the physician visually, to obtain complete, more comprehensive information, the content is sent to a cytological, biochemical and bacterial study.

Pleural puncture. Possible complications

The procedure requires special skills for the doctor, and yet, even with a competent approach, the patient may experience various complications during manipulation. It can be a sharp displacement of the mediastinum, tachycardia, collapse. To avoid such phenomena, the doctor should carefully monitor the patient's condition and during the pleural puncture, clamp the tube with a clamp.

What is the purpose of pleural puncture?

In the pleural cavity of any healthy person, approximately 50 ml of liquid are constantly present. Diseases of the lungs and pleura can lead to the fact that between the leaves of the pleura accumulates edematous or inflammatory fluid. Because it greatly worsens the patient's condition, it is removed by pleural puncture. If there are few liquids, then the patient is made a diagnostic puncture, it helps to determine the presence of pathological cells and determine the nature of the accumulated fluid.

Preparing for pleural puncture

The set for pleural puncture includes a twenty-gram syringe, a needle 7-10 cm long and 1-1.2 mm in diameter and with a steeply pointed point, it is attached to the syringe by a rubber tube. To prevent air from entering the pleural cavity during the procedure, a special clamp is applied to it. A set of two or three tubes will be needed to send the exudate to the study, in addition to them it is necessary to have a sterile tray with tweezers, tampons, wands, as well as alcohol, iodine, collodion and ammonia in case of syncope in the patient.

Pleural puncture with pneumothorax

Spontaneous pneumothorax is also a direct indication for pleural puncture. The technique of carrying out this manipulation is no different from the usual one, except that with pneumothorax from the pleural puncture, air is sucked out by a syringe or pleuroasciration. With the development of valve pneumothorax, air constantly enters the pleural cavity during inspiration. Since there is no reverse drainage, the clamp is not applied to the tube after the puncture, but the air drainage is left. Do not forget that after a pleural puncture the patient should be urgently hospitalized in the surgical department.