Indwelling Pleural Catheter

indwelling pleural catheter

Frequent trips to the hospital is not something anyone desires. However, for some individuals with recurrent pleural effusion, it is a reality that can be exhausting and draining. but with the insertion of an indwelling pleural catheter, these frequent hospital trips can be reduced to a manageable amount.

What is an Indwelling Pleural Catheter?

Before we can understand what an indwelling pleural catheter is, we must first understand the dynamics of respiration. The pleural cavity is essential for respiration, it encapsulates each lung separately and between the space of the pleural membrane and the lung is a small amount of lubricating fluid. This helps the lungs to inflate and deflate during respiration. Pleural effusion, also called water on the lungs, occurs when there is a build-up of excess fluid between the pleural membranes. While having fluid between the pleural membranes is important as a form of lubrication, an excess of fluid can be detrimental to the whole respiratory process.

An indwelling pleural catheter is commonly used in Singapore for malignant recurrent pleural effusions – pleural effusions which keep coming back despite optimal therapy. An indwelling pleural catheter is a long-term catheter that is approximately 66cm long and made of silicone rubber. There is a one-way valve at one end leading into a negative-pressure bottle, which allows fluids and air to go out but not in. 

How does an Indwelling Pleural Catheter work?

An indwelling pleural catheter is inserted into the pleural space to drain the excess fluid out and into a negative-pressure bottle. It is a long-term catheter that can safely drain the excess fluid out without needing to make a trip to the hospital. 

  • Local anaesthesia will be administered at the site of insertion, where two small cuts about 5cm apart will be made. 
  • The catheter is tunneled under the soft tissue of the chest wall before it is inserted into the pleural cavity.
  • The catheter is stitched into place to prevent it from moving.
  • A bandage will be placed over the site of insertion, and you will be given instructions on how to care for it.

Since this is a short procedure, you will be monitored for a while to ensure that the catheter is working, and you are not feeling any discomfort. You will be given instructions on how to drain the pleural effusion, how often to drain it, and how to keep the catheter clean and sterile. Drainage of the pleural effusion can occur once a week to once a day, depending on what is necessary for you. 

How do I prepare for the insertion of an Indwelling Pleural Catheter in Singapore?

Before the procedure, you must avoid eating and drinking for 4 hours and you may be required to stop certain medications such as blood thinners and aspirin. Either local or general anaesthesia will be used during the procedure, depending on your preference and advice of your respiratory specialist. Imaging tests such as an x-ray or a computer tomography scan (CT-scan) may be taken before your procedure to check on the amount of fluid present in your pleural effusion. 

What happens after the insertion of an Indwelling Pleural Catheter?

You may feel a bit groggy after the procedure, so you will be monitored for a few hours to ensure that you recover well. A chest x-ray might be performed after the procedure to ensure that no damage was done to your lungs. 

What are the benefits?

  • Same day procedure and is performed in an out-patient setting
  • Minimally invasive
  • Catheter is not noticeable and does not interfere with daily activities
  • Reduces symptoms of pleural effusion
  • Reduces the need for hospital visits to have the pleural effusion drained

Frequently asked questions

Can the indwelling pleural catheter be removed?

Yes, the catheter can be removed if preferred.

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