Pleurodesis

WHAT YOU SHOULD KNOW:

Pleurodesis (Inpatient Care) Care Guide

  • You may need pleurodesis if you have air or fluid in your pleural space. Your pleural space is found between your lungs and your inner chest wall. When air in your pleural space, you have a pneumothorax. Fluid in your pleural space is called a pleural effusion. You may also have cancer cells in your pleural space called a malignant pleural effusion (MPE). An MPE may be caused by cancer in your lungs, breasts, or lymph nodes. Other diseases such as rheumatoid arthritis may cause build up of substances inside the pleural space. These conditions cause pressure against your lungs, which could result in trouble breathing or chest pain.

  • You may have a surgical or chemical pleurodesis. Surgical pleurodesis is done in an operating room. Chemical pleurodesis is usually done in your hospital room. Before either procedure, fluid and air are drained from the pleural space through a tube in your chest. Your caregiver will use chemicals, powder, or pieces of cloth to irritate the walls of your pleural space. Pleurodesis causes the walls of your pleural space to swell and become attached to each other. This may help prevent air or fluid from collecting in your pleural space. Pleurodesis may decrease your pain and help you breathe easier.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may get a fever (high temperature). Medicines used for pleurodesis may cause you to get an upset stomach. You may get hypotension, which is very low blood pressure. Even after pleurodesis, fluids in your pleural space may not be drained completely. The fluids may build up more and you may need to have pleurodesis again. You might also get an empyema, which is pus in your pleural space caused by germs called bacteria. If you have an empyema, you may need to have it drained through a tube.

  • You may get pneumonia or other serious lung problems. You may get chest pain and your heartbeat might change. You may bleed more than expected. Powder used in pleurodesis may cause your organs to swell or cause you to have an allergic reaction. You may have trouble breathing or even stop breathing altogether. If you do not have pleurodesis, fluid and air may continue to build up in your pleural space. Your breathing problems could get worse. Call your caregiver if you have questions about pleurodesis.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Anesthesia: Anesthesia is medicine to make you comfortable during your procedure. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. If you are having chemical pleurodesis, you may have local or monitored anesthesia. If you are having surgical pleurodesis, you may have general anesthesia. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia.

    • Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your procedure:

  • During surgical pleurodesis, your caregiver uses a scope with a camera connected on its end. After your pleural space is drained, your caregiver cuts your chest and inserts the scope. The scope may be connected to a video monitor that may show the procedure. Through the scope, gauze cloths may be used to dry the walls of your pleural space. Your caregiver may also use laser or heat to irritate your pleural space. A powdery substance is then placed directly on your pleural walls. The scope will be removed and the cut will be closed with stitches.

  • During chemical pleurodesis, your caregiver will use a chest tube to drain excess fluid from your pleural space. Your caregiver will then x-ray your chest to check your lungs and the placement of the tube. Your caregiver will first put numbing medicine into your pleural space through the tube. He will also put chemicals inside the tube that will cause your pleural walls to swell. A clamp will be used to close off the tube for about one hour. Every once in a while, you may be asked to change your position. This is to help the chemical reach every part of your pleural space. The tube will then be connected to a bottle to collect and measure any remaining fluids.

After your procedure:

You may need to stay in the hospital for several days after your procedure. This will allow your caregivers to check how much fluid is draining from your pleural space. A computed tomography (CT) scan may also show if fluid and air still remain in your pleural space. Your caregiver may decide to send you home when your chest tube drains enough fluid every day. You may also need any of the following:

  • Medicines:

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

    • Patient controlled analgesia: You may get pain medicine through an IV or an epidural line attached to a patient controlled analgesia (PCA) pump. Caregivers set the pump to let you give yourself small amounts of pain medicine when you push a button. Your pump may also give you a constant amount of medicine, in addition to the medicine that you give yourself. Let caregivers know if your pain is still bad even with the pain medicine.

  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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