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Pleural disease / Patient information

Indwelling pleural catheter - information for patients

What the tube is, how draining at home works, and the signs that mean ring us today.

Paste block 4 fields 
About your indwelling pleural catheter

Fluid has been collecting between your lung and your chest wall, and it is
making you breathless. Draining it helps, but it tends to come back, and
repeated visits for repeated drainage is a poor way to spend the time you have.

An indwelling pleural catheter is a soft, thin tube placed through the skin
into that space, and left in. It is tunnelled a short distance under the skin,
which holds it in place and reduces the risk of infection. The end sits under a
dressing on your chest.

You, or a district nurse, or a family member we have trained, can then drain
the fluid at home whenever it builds up, without coming into hospital.

Having it put in

It is done under local anaesthetic, usually as a day case, and takes about
30 minutes. You are awake. You may feel pushing and pressure but should not
feel sharp pain - tell us if you do.

Afterwards you will have a dressing over the site. It is common to feel achy
for a few days.

Draining at home

We will drain it [] times a week to begin with, and adjust that according to
how much fluid comes and how you feel.

Drain to symptoms rather than to a target: the aim is that you are comfortable,
not that a particular amount comes out.

Stop draining if you develop chest tightness or a persistent cough during the
drainage, even if fluid is still coming. That is the lung reaching the end of
its stretch, and continuing is uncomfortable and not useful. Try again next
time.

Keep the dressing dry and intact. Do not swim or take baths. Showering is
usually fine with the dressing covered - we will show you.

Over weeks to months, the fluid often reduces and in some people stops
altogether, because the two surfaces stick together. If that happens the tube
can be removed.

Contact us the same day if:

- the skin around the tube becomes red, hot, swollen or painful
- there is pus or an unpleasant smell at the site
- you have a fever, or feel shivery and unwell
- the fluid changes and becomes cloudy or smells
- the tube comes out, splits, or leaks around the site
- you become more breathless, or the fluid stops draining and you are
  breathless
- you have new chest pain.

Infection is the main risk with an indwelling catheter, and it is very
treatable when it is caught early. It is always better to ring.

Who to contact

[team name and number], [hours].
Out of hours: [] .

Practical points

You can usually carry on with normal daily activities, work and travel with the
tube in. Tell us before you fly or travel a long distance, so we can plan.

Tell any other clinician looking after you that you have a pleural catheter,
particularly if you are admitted to hospital or need a scan.

How to use it

The clinical content that most affects how well someone does with a catheter is in two places: drain to symptoms rather than to volume, and stop when the chest tightens. Both are usually explained once, verbally, on the day the tube goes in, when the patient is taking in very little. The list of reasons to ring is written as a list because it will be read in a hurry by a worried person, and infection is named explicitly rather than implied.

Why it says that

None of this is in the copied text. It is here so you can check the block against its source, and change it when the source changes.

Trials behind it

  • AMPLE 2017 Indwelling pleural catheters kept patients out of hospital more than talc pleurodesis
  • TIME2 2012 Catheters and talc relieved breathlessness equally at 6 weeks, with catheters better at 6 months and no admission

Records on respiratorytrials.org.

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