What you should know
- 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.
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.
- 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.
The week before your procedure:
- Ask someone to drive you home when you are ready to leave the hospital. Do not drive yourself home.
- Ask your caregiver if you also need to stop using aspirin or steroid medicines. He may also tell you to stop using other prescribed or over-the-counter medicines before your procedure.
- Tell your caregiver about other diseases or conditions you may have such as cancer. Tell him if you have bleeding problems or allergies to medicines such as anesthesia. Also tell your caregiver if you have had other procedures or surgeries in your chest or lungs.
- Your caregiver may need to take a sample of the fluid inside your pleural space for testing. You may also need to have blood tests done before the procedure. Imaging tests such as chest x-rays, ultrasound, or a computed tomography (CT) scan may be needed. Your caregiver may also ask you to have a positron emission tomography (PET) scan or magnetic resonance imaging (MRI). Your caregiver may use these tests to guide where he will put your chest tube. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.
The night before your procedure:
- Ask caregivers about directions for eating and drinking.
The day of your procedure:
- Write down the correct date, time, and location of your procedure.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist may talk to you before your pleurodesis. This caregiver may give you medicine to make you sleepy. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
What will happen:
- You may be given general anesthesia if you are having a surgical pleurodesis. 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. A powdery substance will then be placed directly on your pleural space. Your caregiver may also use laser or heat to irritate your pleural space. The scope will be removed and the cut will be closed with stitches.
- You may be given local or monitored anesthesia if you are having a chemical pleurodesis. Your caregiver will put a tube in your chest and drain any excess fluid from your pleural space. Your caregiver will then put the chemical into your chest tube and clamp it. Every once in awhile, you may be asked to change your position. This is to help the chemical reach every part of your pleural space. The tube will be unclamped and 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 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.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to your procedure.
- You get sick (a cold or the flu).
- You have a fever.
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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.