How to Manage a Tunnelled Pleural Catheter Effectively

Have you or a loved one been advised to undergo a tunnelled pleural catheter insertion, and are unsure of what this entails? We will walk you through the steps and what to expect in this article.

At Interventional Pulmonology and Lung Clinic in Singapore, we are experts in lung issues and treatments that offer our patients an improved quality of life. Tunnelled pleural catheter, also known as indwelling pleural catheter, is a treatment commonly used for malignant recurrent pleural effusions.

The purpose of a tunnelled pleural catheter 

A pleural effusion, commonly known as water in the lungs, happens due to excess fluid build-up between the pleural membranes. While it is normal to have some fluid in the pleural membranes of the lungs as a form of lubrication, too much fluid can have serious health consequences. This can be caused by infection, tuberculosis (TB), or cancer.

Besides these risks, having fluid build-up in the lungs also causes unpleasant symptoms such as:

  • Chest pain
  • Coughing
  • Fever
  • Rapid breathing
  • Shortness of breath
  • Hiccups 

A tunnelled pleural catheter is a catheter that is placed in the lungs for long-term use. It is approximately 66 cm long, made of silicone rubber, with a one-way valve that leads into a negative-pressure bottle. It allows patients to better manage their symptoms from recurrent malignant pleural effusions at home without frequent hospital visits. It works by allowing the drainage of excess fluid through the catheter. 

tunnelled pleural catheter
A tunnelled pleural catheter enables drainage of pleural effusions (fluid) at home.

Inserting a tunnelled pleural catheter

The process of inserting a tunnelled pleural catheter is often a simple procedure. While you can be awake during the procedure, patients may be placed under sedation to minimise discomfort and pain. Complications may include bleeding and infection, but these are rare.

During the procedure, the catheter is slid into small cuts on the chest and into the pleural space. It will be stitched to keep it in place, and then a bandage is placed over it. Some of the effusion fluid may be drained with the catheter to ensure that it is working properly. Afterward, you may be able to go home with instructions from the doctor on when you can shower, change the dressing, and so forth.

excess fluid buildup
A tunnelled pleural catheter can relieve symptoms caused by excess fluid buildup in the lungs.

Caring for a tunnelled pleural catheter at home

Since the catheter is designed to allow you to manage pleural effusions at home, it is important that you or your caregiver receive proper instructions from your doctor on how to drain and clean it. Make sure that you are well-informed and ask any questions you may have before you leave the hospital after the tunnelled pleural catheter insertion. 

Depending on the severity of the lung condition, the amount of drainage you can expect will differ from patient to patient. Your doctor will inform you of this. You will also be given instructions on how to keep the catheter clean and sterile to reduce the risk of infection.

It is also a good idea to keep a log every time drainage is needed so that you can inform your doctor if there are any changes. This includes taking note of the amount of fluid drained, the colour, and any other symptoms you may have. 

Some patients may feel some pain during drainage, so it is important to let your doctor know at your next appointment so that he can prescribe you pain medication if necessary. Plus, your output may slow down, which means that you may no longer need a catheter, which is why monitoring the amount of drainage is often advised.

Always ensure that your hands are clean before and after drainage, or when changing dressings. Wash your hands with soap or use an alcohol-based hand sanitiser. If your catheter moves or accidentally comes out, or if there are any signs of a potential infection, contact your doctor immediately. 

tunnelled pleural catheter
A tunnelled pleural catheter may be a temporary solution and can be removed when no longer needed. Image: Dana Li et al. Clin Med 2021;21:e561-e566

When to remove a tunnelled pleural catheter

For some patients, needing a pleural catheter is a temporary solution. When the effusions dry up or fluid output slows down drastically, your doctor may suggest removing it. In general, many patients are able to have their catheter removed 3-4 months after insertion.

Contact us if you have questions about lung conditions or tunnelled pleural catheters.


  1. Indwelling Pleural Catheter, 2023. Retrieved from: IP Lung Clinic. 
  2. About Pleural Effusion, 2023. Retrieved from: Penn Medicine. 
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