Pleural effusion (treatment for fluid on the lungs)

Fluid can build up between the tissue layers that surround the outside of the lung, and the lining in the chest cavity when cancer is present. These tissue sheets are known as the pleura.

This fluid collection is called a pleural effusion by doctors.

This fluid prevents your lungs from expanding fully when you breathe. As the fluid builds up, it causes shortness in breath.

Coping

A pleural effusion can cause shortness of breath, which can be extremely uncomfortable. If you experience difficulty breathing, you might feel anxious.

It might be more comfortable to lie on the bed edge or in an armchair. To allow your lungs as full expansion as possible, lean forward and rest your arms on a pillow placed on a bed.

If you have difficulty coping, let your nurse or doctor know. They may be able to prescribe medication to assist you.

Treatment

Treatment can be provided to prevent fluid buildup and relieve symptoms.

This is known as pleurodesis. The sterile talc is used to inflame the tissue covering the lung and make it stick together. This ensures that fluid cannot collect in the space.

If you’re well enough, you can have it done outpatient. If there is a lot fluid left to drain, you may need to stay overnight in the hospital. It can be a long process and your nurses will need to monitor you closely.

It doesn’t cure cancer. It should make it easier to breathe afterward. If it doesn’t work the first time, you can get it again.

fluidinChest_pleural-effusion

Pleurodesis: How do you get it?

This treatment can be done in a variety of ways depending on how much fluid needs to be drained.

Your doctor may place a thorascope in your chest to drain any fluid that is not needed. The pleura will be placed between the coverings and the lungs. The doctor can see the tube through it so they can pinpoint where the powder should be placed. The powder can be inserted through the tube of the thorascope. This method of pleurodesis can be called video assisted thoracoscopy.

Your doctor will give you a small amount of local anaesthetic if you require fluid to be drained between your pleura. Once the anaesthetic is effective, the doctor will insert a cannula (wide needle) into your chest. This usually goes through your side.

The needle’s tip is inserted into the pleural space where fluid is collecting. Once the needle is in the correct place, the doctor attaches it to a drainage tube, called a chest drain. This is then attached to a bottle or bag. To hold the tube in place, your doctor will wrap a stitch around it. This is known as a purse string suture.

The fluid will drain out as long as it is not higher than your chest. This can take up to several hours if there is a lot of fluid.

You should do it slowly because if you drain too much fluid quickly, your blood pressure can drop abruptly and make you feel faint. You may also feel more breathless if your lungs expand too fast.

The doctor injects the powder through the drainage tube into the pleural space once the fluid has stopped draining. The doctor then clamps the tube and leaves it for one hour. You will need to be in different positions to help spread the powder around your pleural space. The doctor might ask you to turn your head from one side to the other. The drain may then be connected to suction. This will help to keep the pleura together.

You may need to take painkillers before you start this part. Most people feel no pain and it doesn’t last for long. If it becomes a problem, tell your doctor.

Your doctor or nurse will then take out the tube and pull the thread tight to close the small hole in your chest wall. It should stay in place for approximately a week.

Researchers are looking into ways to drain fluid from the lungs

Research continues to be done on ways to drain fluid from the lungs.

The OPTIMUM trial

This trial examines 2 methods to treat fluid around the lungs.

Researchers are comparing the traditional method of draining fluid around the lung and sticking the membrane together with a new one. This new method uses a tube which stays in the pleural space for a long time.

It’s also known as an intrapleural catheter (IPC).

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