Indwelling Pleural Catheters

The catheter is usually inserted as an outpatient procedure or during a short stay, using local anesthetic and sometimes light sedation. The tube is tunneled under the skin for a short distance, which helps hold it in place and lowers infection risk. A small valve on the outside end stays closed until drainage. A dressing covers the site. Placement is often done with ultrasound or during thoracoscopy. Your team explains how to care for the site while it heals. Stitches are often removed after a week or two, and the dressing is changed regularly. Many people return to normal activities quickly after placement.

Drainage uses sterile bottles or bags that connect to the valve. A home health nurse typically teaches patients and family members how to drain. Many people drain a few times a week, following their team's instructions on frequency and amount. Some patients find drainage decreases over time as the lining seals on its own, and the catheter may eventually be removed. Keep a log of how much fluid comes out each time. Drain only the amount your team advises, and stop if you feel chest discomfort or start coughing. A family member can learn to help, which is useful on days you feel unwell. Your nurse will review your technique at follow-up visits.

Signs of infection include redness, warmth, swelling or pus at the site, fever, or cloudy fluid. Report these right away. Also call if drainage suddenly stops, the catheter is damaged or pulled, or breathlessness worsens despite drainage. Keep the dressing clean and dry, and ask how to shower safely. Keep extra supplies on hand and know how to reorder them through your supplier. Store supplies in a clean, dry place. Leaking around the catheter or pain during drainage should also be reported. Your team can arrange a nurse visit if you are unsure what you are seeing, and prompt attention usually prevents bigger problems.

1. 1

   Ask a home health nurse to train both you and a family member on drainage.

2. 2

   Keep a written log of drainage dates, amounts and fluid appearance.

3. 3

   Learn the signs of infection and call your team if any appear.

4. 4

   Confirm how to reorder drainage supplies before your stock runs low.