What is PleurX Catheter Placement?
PleurX catheter placement is a treatment option for recurrent pleural effusion or fluid collection in the abdomen. This is a minimally invasive technique which enables the removal of the excess fluid at home, avoiding the need for regular visits to a doctor for the fluid drainage process.
Pleural Anatomy
The pleura is a thin membrane that lines the outside of the lungs(visceral pleura) and the inside of the chest cavity (parietal pleura). There is a potential space between the visceral and parietal pleura containing a small amount of lubricating fluid, which allows effortless and efficient respiration. Certain disease conditions cause a buildup of fluid in the pleural cavity, which makes it difficult to breathe.
Candidates for PleurX Catheter Placement
People with fluid buildup in the chest or abdomen due to lung cancer, liver disease, metastatic cancers, chylothorax, or advanced congestive heart disorder are generally considered for this procedure.
Preparation for PleurX Catheter Placement
Your doctor will assess your symptoms and perform an examination. Imaging tests such as X-ray, MRI, or CT-scanning may be ordered. Inform your doctor about the medicines you are taking prior to the procedure, and if you are allergic to any medicines or anesthesia. Arrange for someone to drive you home after the surgery.
PleurX Catheter Placement Procedure
- The procedure can be done in an outpatient setting.
- An intravenous line will be placed into your arm to provide sedation.
- The catheter insertion site on your chest will be numbed with an anesthetic medication.
- An incision will be made into the pleural space and a second incision a few inches away.
- A tunnel will be made under the skin between the 2 incisions.
- The PleurX catheter with a 1-way valve that only allows fluid to come out will be passed through the tunnel and capped.
- The exterior end of the catheter is usually placed under a bandage when not in use.
- The entire procedure can be completed in about 45-90 minutes.
Drainage of Fluid using the PleurX Catheter
To drain the fluid, you will need to connect the outer end of the catheter to the drainage line on the vacuum bottle which is provided as part of the Pleurx drainage system following the directions given by your doctor or nurse. The vacuum bottle will automatically draw out the fluid through the catheter.
Risks of the PleurX drainage system
- Chest fluid drainage: Potential complications include pneumothorax, re-expansion pulmonary edema, hypotension, circulatory collapse, and infection of the pleural space. Do not drain more than 1,000 mL of fluid from your chest at any one time.
- Abdominal fluid drainage: Potential complications include hypotension, circulatory collapse, electrolyte imbalance, protein depletion, ascites leakage, peritonitis, wound infection, and loculations of the peritoneal space. More than 2,000 mL of fluid should not be removed from your abdomen at any time.
Benefits of Tunneled Pleural/Peritoneal Catheters
The benefits of the PleurX Catheter drainage system include:
- Ability to do repeated fluid drainage at home
- Greater patient flexibility and independence
- Better management of symptoms
- Less risk for needing large-volume paracentesis
