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Indwelling Pleural Catheter Insertion

The surgeons recommend Indwelling Pleural Catheter (IPC) insertion in patients with pleural effusions. The most common cause of pleural effusion that requires IPC insertion is malignancy-induced pleural effusion. However, IPC insertion is also effective in managing non-malignant effusions. It manages recurrent pleural effusions, improves shortness of breath, and enhances the overall quality of life.

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  • Preparing Patients for the Procedure: During the consultation before the procedure, the patients are provided with all the instructions related to preparing for the procedure. The patients should avoid taking medications that increase the risk of bleeding, such as aspirin, at least a week before the surgery.
  • IPC Insertion Technique: The insertion of the IPC in the patient can be performed in any position that allows adequate fluid collection. The incision site is cleaned with a disinfectant solution, and the local anesthetic agent is applied. In the numb area, the surgeon makes two cuts and inserts the catheter in the cuts. Although the patients may not experience pain, slight discomfort may occur due to pressure. Next, the surgeon stitches the catheter to seal it in place.
  • Drainage Technique: The frequency of initial drainage may be about three times per week. The subsequent frequency adjustments may be made based on the fluid volume and the symptoms experienced by the patients. IPC insertion does not have cosmetic concerns, as the catheter is invisible under the clothes.
  • IPC removal: There are several reasons for the removal of the IPC. It includes drainage of sufficient fluid, irreparable catheter blockage, pain due to IPC, and permanent damage to IPC. Further, the drain may result in local fibrosis, which makes the removal more difficult if the catheter remains inserted for a long time. IPC can be removed by pulling the catheter after cutting the sutures and removing the fibrous tissues, if any.

Faq's

What are the advantages of IPC?

IPC offers several advantages to patients suffering from pleural effusions. These include improved quality of life, low failure rate, low initial cost, and fewer days of hospitalization. The procedure for insertion is also performed as an outpatient,

What are the complications associated with IPC?

The complications associated with IPC insertion are pain during insertion, bleeding, infection, lung injury, catheter blockage, catheter dislodgement, and catheter tract metastases. Some of these complications are managed through medications, such as analgesics and antibiotics. The others are managed by replacing or removing the IPC.