Management of Pleural Effusions and Ascites
Malignant pleural effusions can cause severe shortness of breath and even respiratory failure. Simple drainage of the fluid can be performed on an outpatient basis for relief of symptoms and for diagnosis. Unfortunately, these effusions will rapidly reoccur often requiring multiple procedures, each causing significant inconvenience and discomfort to the patient as well as risking infection with each tap. We offer a solution to this problem with the Denver PleurX implanted catheter. This device is a tunneled catheter with a cuff that can be placed either at UNC REX Hospital or in our outpatient interventional suite in Cary. This is a relatively simple procedure performed under local anesthesia. Once placed, the fluid is drained completely. The patient goes home with a supply of evacuated containers that are attached to the catheter daily to drain the fluid. The tube is then capped and coiled beneath their clothing. Drainage will stop in up to half of patients within a few weeks. The drainage bottles and supplies are available in the area or directly through Denver medical. A videotape supplied with the kits and patient instruction in the office is usually sufficient for patients or their family members to learn this process. Malignant ascites can be managed in a similar manner with placement of a tunneled catheter for home management and drainage of the ascites. Larger volume evacuated bottles are provided for this system. Again the goal is to avoid repeated visits to the office or other facility for drainage of the fluid with all of the attendant risks and inconvenience to the patient.