Pleural Fluid Analysis

The pleural cavity is the space between the outer lining of the lungs and the chest wall. Collection of fluid in this space may be attributed to a condition referred to as pleural effusion. Pleural fluid analysis is a test that is carried out on this fluid to ascertain the actual cause of the pleural fluid.Although there are several known causes of this condition, including malignant tissues, CCF and infections like pneumonia, the following are some of the circumstances that may lead to the condition:

  • Drainage obstruction within the chest cavity
  • Increased accumulation of fluid within the cavity
  • Impaired lymphatic clearance of the fluid within this cavity
  • Increased venous pressure

To examine the fluid, the doctor may either use a thoracocentesis or pleural tap procedure.

What Is Pleural Fluid Analysis?

The analysis of pleural fluid is also referred to as thoracentesis. Under normal circumstances, the pleural cavity contains about 20 ml of a clear to yellow-colored fluid. If this fluid is in excess, it may lead to a condition referred to as pleurisy or pleural effusion. Pleural effusion manifests itself in an array of symptoms, such as coughing and shortness of breath. The condition may be diagnosed using ultrasound or an X-ray scan. After diagnosis, surgeons will conduct a pleural effusion analysis on the fluid to determine the cause of the condition. After the analysis, the surgeon may then use thoracentesis to draw the excess fluid, in a bid to ease the discomfort associated with pleural effusion and allow the patient to breathe normally. While this test is necessary, it cannot be carried out on certain patients, including the ones with clear signs or known history of heart failure, people with blood clotting problems and people on blood-thinning medications.

When Is Pleural Fluid Analysis Needed?

The doctor will order for this analysis if he or she suspects that you have a disease that is causing the effusion or when you are showing signs of a bloody pleural effusion. Some of the symptoms that may prompt your doctor to order for this test are:

  • Chest pain that gets worse when you inhale deeply
  • Fever and chills
  • Coughing
  • Shortness of breath and or difficulty in breathing
  • Fatigue

How Is Pleural Fluid Analysis Performed?

Pleural effusion analysis may be carried out in a day-surgery setting or in a hospital by a qualified surgeon. Prior to the actual procedure, the doctor may carry out ultrasound and X-ray analysis of your chest. Additionally, your blood will be analyzed to determine its clotting properties. When you show up for the analysis, you will be asked to sit on a bed or an armless chair. The physician will then help you lean forward and rest your head and arms on a table in front of you. As the procedure goes on, you are supposed to remain still. The physician will then clean the skin on your back and side with an antiseptic. This will feel a bit cold.

After cleaning the skin, the surgeon will then inject you with a local anesthetic; this will sting a bit before the region around your ribs and the back goes nub. Once the tissues are nub, the surgeon will insert a hollow needle in between the ribs to extract the excess fluid in the pleural cavity, which is then collected in a bottle. While the surgeon is extracting the fluid, you may experience a strong urge to cough or a certain level of discomfort. Once the fluid is collected, it is sent to the laboratory for analysis.

Are There Any Risks Associated with Pleural Fluid Analysis?

Basically, thoracentesis is a considerably safe procedure, especially when carried out by a professional physician under the guidance of an ultrasound. As such, many patients undergo ultrasound prior to pleural fluid analysis. Complications as a result of this thoracentesis procedure are normally minimal. Even when they occur, the majority of them are not serious and may be easily treated or heal on their own. Some of the complications that are associated with this procedure include:

  • Pulmonary edema – This is a condition in which additional fluid accumulates within the lungs. This will occur when a large amount of fluid is sucked out during the procedure.
  • Bleeding and infection
  • Damage to the spleen or liver by puncturing - this is very rare.
  • Pain - During the procedure, you may experience some pain, which is expected to cease when the catheter is removed.
  • Pneumothorax – This is the collapsing of the lungs, if punctured. This complication occurs in about 10 percent of patients who undergo pleural fluid analysis. However, the damage is very small and can heal on its own within a short period. If the puncture is large or continues to expand, the patient may be hospitalized and a chest tube may be used to re-expand the affected lung.
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