Pleural catheterization

Pleural catheterization is a procedure that’s done to treat a condition called pleural effusion. This disease causes fluid to repeatedly build up in the area between your lungs and your chest cavity, known as the pleural space, and causes shortness of breath. During a pleural catheterization procedure, a soft silicone tube called a catheter is placed in the pleural space, with the other end of the tube on the outside of your body. This allows you to drain the fluid regularly and breathe with more comfort.

When pleural effusion affects your quality of life, Penn Medicine Interventional Pulmonology has a full range of treatments that includes pleural catheterization. Whether you have malignant pleural effusion or another condition that causes fluid buildup in the pleural space, our doctors are experts at inserting indwelling tunneled pleural catheters as part of your treatment plan.

You may need a pleural catheter if excess fluid continues to collect around your lungs. Doctors can remove the fluid in the hospital with a procedure called thoracentesis, but sometimes the fluid quickly returns. This can happen if you have malignant pleural effusion, which is caused by lung cancer, mesothelioma, breast cancer, lymphoma, or other cancers. Other conditions, like congestive heart failure, can also lead to too much fluid around your lungs.

Persistent symptoms that can be relieved by draining pleural fluid include:

• Shortness of breath
• Cough
• Chest pain
• Fatigue
• Weight loss

Follow your doctor’s instructions about how to prepare for pleural catheterization, including when to stop eating and drinking. You might also need to stop taking certain medications before your appointment.

During the procedure:

• You may be given sedation through a vein in your arm to help you relax and make you feel sleepy.
• Your doctor will do an ultrasound, which will help guide the procedure.
• Your skin will be disinfected, and a local anesthetic will be injected into your tissues to numb the area.
• After the local anesthetic takes effect, your doctor will make two small incisions to create a path for the pleural catheter.
• Your doctor will then pass the pleural drain into the pleural space.
• You’ll be given stitches to help hold the catheter in place.
• Then your doctor covers the area where the end of the catheter leaves your body with a sterile bandage.

You’ll be monitored after surgery before going home. Your health care team will let you know how to use your catheter for pleural drainage, how to keep it clean, and how often to change your dressing.

It's common to have soreness in your chest for about a week after the procedure, which you can manage with pain medicine. Your stitches will be removed a couple of weeks after the procedure.

Minor bleeding can happen when the catheter is placed, but it usually stops on its own. There’s also a risk of infection, which can be lowered by closely following your health care team’s instructions on using and cleaning your pleural catheter. If an infection does occur, your doctor can prescribe an antibiotic to treat it. Your pleural catheter might also become blocked with a thick buildup, but you can flush it with a saline solution or use a medication to clear it. Talk to your health care team if you have any concerns about pleural drainage or your catheter.

It’s uncomfortable to breathe when pleural fluid collects around your lungs, but a catheter can help relieve your symptoms. Penn Medicine provides complete care if you have malignant pleural effusion or another condition that causes pleural fluid to accumulate. Our experts are skilled at diagnosing and treating these diseases, including inserting pleural catheters to allow you to drain the fluid yourself and breathe easier. You'll also get thorough training from your health care team on how to use and clean your pleural catheter. We’re here to guide you through every step to feel better.