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Dr. Jacques Fontaine is board certified by the American Board of Surgery and the American Board of Thoracic Surgery. He currently practices Thoracic and GI Oncology at H. Lee Moffitt Cancer Center in Tampa, Florida.Make an Appointment
Extra fluid that builds up around your lungs can prevent them from expanding and cause you to feel short of breath. A PleurX catheter acts as a drain and makes it easier for you to breathe. Proper care for your catheter will maximize drainage and prevent complications such as infection.
What Is a PleurX Catheter?
A PleurX drainage catheter is a small, flexible tube that doctors place within the patient’s chest to drain fluid from the pleural space. The pleura are layers of tissue that surround your lungs and chest cavity, and a small amount of fluid between the tissue layers helps your lungs expand and contract.
Doctors recommend a PleurX catheter for patients with certain thoracic diseases, such as lung cancer, which can cause excess fluid to accumulate in the pleural space and restrict lung movement. The PleurX catheter drains fluid buildup and reduces uncomfortable or painful symptoms for patients with pleural effusions.
What to Expect from a PleurX Catheter Placement
Your doctor will place your PleurX catheter during a procedure that takes about 45 to 90 minutes. You will have time to ask questions before you sign the consent form, and a nurse will provide instructions on home care before you leave.
Steps for a PleurX Catheter Placement
- A nurse will place an intravenous (IV) line in your hand or arm.
- Once in the procedure room, you’ll receive medication to make you drowsy.
- Your doctor determines placement of the PleurX catheter based on the affected lung.
- You will receive a local numbing anesthetic to prevent pain from the incisions.
- Your doctor will make one small incision into the pleural space and a second incision nearby, passing the catheter between the openings through a tunnel under the skin.
- The catheter drains the fluid through its multiple openings and has a valve to block air.
- When the catheter is in place, your doctor will either cap it or collect initial drainage.
- The medical team will clean the catheter site and dress your incisions with bandages.
- Once fully awake in the recovery room, your nurse will provide home-care instructions.
PleurX Catheter Care
Performing appropriate cleaning and care of your PleurX catheter will prevent complications and allow the drain to function as intended. After a little practice, you will become familiar with the necessary steps of inspecting your catheter, draining the fluid and replacing the dressing when needed.
Inspect Your PleurX Catheter
Before each attempt to drain fluid, you should inspect the catheter and the surrounding skin. Some patients may find that using a mirror is helpful to see the entire area. Your skin should be free of redness, bleeding, rash or discharge.
There should be no kinks or damage to the tubing. Avoid using sharp objects around the PleurX catheter to prevent accidental damage to it. There also shouldn’t be any fluid leaking around the catheter site.
Drain Your PleurX Catheter
You should drain the fluid whenever you are feeling short of breath. For most patients, this is typically every two to five days. You should never remove more than 1,000mL in a single sitting. Notify your doctor if you feel short of breath after draining.
Draining your PleurX catheter takes about 5 to 15 minutes, and the steps are as follows:
- Wash your hands with soap and water for 1 minute.
- Tighten the roller clamp so that the bottle’s drainage line is completely closed.
- Remove the cap and clean around your catheter’s valve using an alcohol wipe.
- Insert the access tip from the drainage line into the catheter valve.
- Activate the vacuum in the bottle by pushing the plunger to break the seal.
- Release the roller clamp on the drainage line to control the drainage flow rate.
- When the drain has slowed, or the bottle is full, close the line again with the clamp.
- When you have finished draining, pull the access tip out of the catheter valve, clean the catheter valve with a new alcohol pad and twist a new cap into place.
It is essential that you keep your worksite as sterile as possible during the draining. Avoid touching either the exposed catheter valve or the access tip. The PleurX catheter drainage color should be between pink and red, but report any changes in color to your doctor’s office.
A slight cough or chest discomfort is normal while the fluid is draining, but you should slow or stop the drain if the pain is severe or persists.
Consult your doctor if you are unsure of any steps in the draining process or if you experience any issues such as an abnormal drainage color, bleeding or pain.
Replace the Dressing
Clean around the catheter site with a new alcohol pad and place the foam catheter pad against the skin. Wind the catheter into a small coil above the catheter pad and cover it with gauze pads. Cover the area with the transparent, self-adhesive dressing, centering it over the gauze pads and pressing down firmly from the center toward the edges to seal it.
Frequently Asked Questions
Can I shower with my PleurX catheter?
It is safe to take a shower if the self-adhesive dressing is securely in place over the gauze. The dressing will typically keep water out, but if there is any sign of wetness on the gauze, dry the area and re-dress the site with fresh materials.
What if I have PleurX catheter complications?
If you experience any pain, difficulty breathing, changes in drainage color or other abnormalities, stop the drainage and notify your health care team as soon as possible. Contact your doctor’s office if you have difficulties draining at home, and they can guide you through the process.
What should I do if the drainage changes color?
PleurX drainage usually is between pink and red in color. However, you should discuss any concerns regarding color change or fluid appearance with your doctor.
How long can a PleurX catheter stay in?
The catheter can stay in your chest for as long as necessary to completely drain the excess fluid. Most patients will use a PleurX catheter for several months, but duration will vary among patients.
When can the PleurX catheter be removed?
Your doctor will remove the PleurX catheter once drainage is less than 50mL after three attempts. Notify your doctor’s office once this occurs, and they will schedule an appointment to discuss removing the PleurX catheter.