Drainage of pleural effusion

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							Are there any other ways of                                                                                                    Sunderland
managing pleural effusion?                          Additional information                                             Teaching Primary Care Trust


A drug called bleomcyin or tetracycline or          q   Usually, fluid will be drained off slowly
sometimes talc is injected through the drain            as a sudden release of pressure in the
to help seal the two layers of the pleura               chest can cause a drop in blood pressure.
together to prevent the fluid from building             When the drain is first inserted, a litre
up again. This is known as pleurodesis.                 of fluid may be drained safely. After
The doctor injects the drug through the drain           this, drainage should be slower. Your
and then leaves the drain clamped for                   blood pressure will be monitored.
approximately one hour.
To help the drug circulate properly, you will
                                                    q   The chest drain can become blocked.
                                                        This can sometimes be resolved by
                                                                                                      Drainage of
be asked to lie in various positions in the bed
(e.g. on your back, front, left and right sides).
                                                        changing position or sitting upright.
                                                        Occasionally the drain may need to be
                                                                                                      pleural effusion
The drain may be attached to a suction
                                                        replaced.
machine to apply a small amount of pressure
and help the pleura to seal together.
                                                    q   The drain is also a possible source of
When the drain is removed, the stitch is pulled         infection. Your temperature will be
together, sealing the wound. Usually, the stitch        checked for any signs of infection.
is removed a week later. The area is covered        q   If a pleurodesis is necessary, chest pain
with a small dressing.                                  may occur for a day or so after
It is possible for the pleural effusion to happen       treatment and you may need to take
again, and drainage may need to be repeated.            painkillers.
The doctor may also prescribe a diuretic (water     q   If your drainage tube is attached to a
tablet). This can make you want to pass more            bottle, you will be able to walk about
urine than normal but will slow down the                with it. It is important to be careful with
build-up of the pleural effusion.                       the bottle and it should not be raised
Further treatment of the cancer may require             above the chest as the fluid could go
some chemotherapy or hormone therapy. This              back into your lungs.
will help prevent fluid from building up again.
                                                                St. Benedict’s Hospice
                                                             Monkwearmouth Hospital
                                                         Newcastle Road, Sunderland, SR5 1NB
                                                                       Telephone:
                                                                    (0191) 569 9195
                                                                 www.hospice.co.uk
                                                                                                      St. Benedict’s
                                                             REGISTERED CHARITY NUMBER 1019410         H O S P I C E
This information leaflet has been prepared       What causes a                                      Drainage of a
to help you understand more about drainage
of fluid from the area of the lungs (pleural
                                                 pleural effusion?                                  pleural effusion
effusion).
                                                 Pleural effusions are quite common and are         Treatment for pleural effusion involves slowing
We hope it will answer any questions you
                                                 often due to infections (such as pneumonia),       the build-up of the fluid, and draining it to
might have about your condition and the
                                                 or heart failure (when the heart is not            relieve the symptoms. The drain is usually
proposed treatment.
                                                 pumping the blood efficiently around the           inserted by a doctor, who will ask you to sit
If you are unsure or concerned about
                                                 body).                                             on a chair or on the edge of the bed and lean
anything, please ask the nurse or your doctor.
                                                 A pleural effusion can also be a symptom of        over a table with a pillow to support you.
                                                 several types of cancer. This usually develops     To prevent infection, the area where the drain
                                                 if cancer cells have spread to the membrane        is to be inserted will be cleaned with an
What is a pleural effusion?                      lining the lungs, where they can lead to           antiseptic solution. A local anaesthetic
                                                 irritation and cause fluid to build up.            injection will numb the area so the procedure
The lungs are covered by a lining or             The types of cancer that are more likely to        won’t be painful.
membrane called the pleura which has two         cause a pleural effusion are lung cancer,          Through a very small cut in the chest, the
layers, an inner layer and an outer layer. The   breast cancer, lymphomas and mesothelioma          doctor puts a needle called a cannula.
outer layer lines the rib cage and diaphragm     (cancer of the lining of the lungs).               The cannula is then attached to a tube and
(which separates the chest from the                                                                 drainage bag or bottle, allowing the fluid to
abdomen), and the inner layer covers the                                                            drain from the chest. Drained fluid may be
lungs. The pleura produces a fluid that acts                                                        bloodstained, so don’t worry.
as a lubricant that helps you breathe easily,                                                       If there is a large amount of fluid, you will
allowing the lungs to move in and out                                                               usually need to stay in hospital for a couple
smoothly. Sometimes an excess of this fluid      What are the signs                                 of days. The cannula may be held in place
can build up between the two layers and          and symptoms?                                      with a small stitch. If there is only a small
this is called a pleural effusion.                                                                  amount of fluid, the cannula is removed
                                                 The build-up of fluid around the lungs presses     immediately after the procedure and the area
                                                 on one or both of them. This makes it very         covered with a dressing.
                            Trachea              difficult for the lung affected to expand fully.   When the local anaesthetic wears off, you
                                                 It can make you increasingly breathless, not       may have some pain or discomfort. If so, let
                            Right lung
                                                 only on exertion but at rest as well. You may      the doctor or nurse know as you can be
                            Pleura               also get some chest pain and a cough.              prescribed medication to help.
                            (lung lining)                                                           Once the doctor believes that most of the
                                                                                                    fluid has drained, you may have a chest x-ray
                            Pleural effusion
                            (fluid in the                                                           to see if your lung has re-expanded.
                            pleural space)                                                          Depending on this, the drain will be removed.

						
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