Pleurodesis

Pleurodesis is a procedure where a mildly irritant drug is introduced into the space between the inner wall of the chest and the outer lining of the lung (pleural space). This is done to prevent the recurrence of a lung collapse (pneumothorax) or accumulation of air or fluid in the space (pleural effusion).

The procedure can be done in two different ways:

• Chemically – This involves putting chemicals such as bleomycin, tetracycline, povidone iodine or slurry of talc into the pleural space. These chemicals will irritate the lining of the lungs causing it to inflame and closes the space thus stopping the re-accumulation of air or fluid. This is a painful procedure so; anaesthesia may be given to the client.
• Surgically – This involves opening the chest and irritating the inner wall of the chest using a rough pad.

Reason

Accumulation of fluid or air in the pleural space may cause difficulty in breathing. By performing pleurodesis, breathing activity will be improved. The doctor will also recommend this procedure to prevent the accumulation of fluid or air to happen in the future.

Procedure

If there is already an accumulation of fluid or air in the space between your inner chest wall and outer lining of the lung, a tube is surgically placed into the chest to drain it out. Once it is completely drained, the irritant drug will be injected through this drain commonly in a liquid form. Then it will be sealed for approximately 2 hours. It will be re-opened if there is still more fluid or air present and usually left in place within 24-72 hours or even longer before it is removed.

Risks

Like any other medical techniques, this also involves certain risks such as:

• Chest pains (treatment: painkillers)
• Fever (treatment: Paracetamol)
• Difficulty in breathing (although rare but can be fatal; treatment: oxygen)
• Infection (treatment: Antibiotic)

Results

There are about 7-8 out of 10 cases (70%-80%) that collection of fluid or air in the pleural space is likely to happen again. If it does, your doctor may require another pleurodesis procedure and it may not be as successful as the first.

Recovery

• Medication treatment. Follow the medication given by your doctor and inform them if you are allergic to any medicines. If the pain continues, inform the doctor right away so you will be given another type of painkiller.
• Rest. Strenuous activities may cause the stitch to come apart so, resume in your daily activities one at a time.

Alternative

Pleurodesis generally requires you to stay in the hospital for a longer period but the doctor may recommend a small flexible tube (indwelling pleural catheter) to be surgically inserted in the chest where you can go home with it and be taught how to drain or a nurse will visit you at home to drain it themselves.