Is a PleurX (pleural catheter) inserted bedside or in the Operating Room (OR)?

From the Guidelines

A PleurX (pleural catheter) is typically inserted bedside.

Key Points

• The procedure is usually performed in an ambulatory setting via a tunneled technique, providing access to the pleural space for fluid drainage when symptoms recur 1.
• This approach is less invasive and has been shown to reduce dyspnea and improve quality of life (QOL) in patients with malignant pleural effusions 1.
• The use of indwelling pleural catheters is preferred in patients with non-expandable lungs, as it provides a means for palliation from dyspnea related to recurrent malignant effusions 1.
• Placement of indwelling pleural catheters is also recommended for recurrent malignant pleural effusions to avoid repeated hospital drainage or admission 1.

Procedure Details

• The insertion of a PleurX catheter is a relatively simple procedure that can be performed at the bedside, eliminating the need for an operating room setting.
• The tunneled technique involves creating a small incision and inserting the catheter into the pleural space, which is then secured with a tunneled catheter.
• This approach has been shown to be safe and effective, with a low rate of major complications, such as empyema and cellulitis 1.

From the Research

Insertion of PleurX Catheter

• The studies do not explicitly state whether the PleurX catheter is inserted bedside or in the Operating Room (OR) 2, 3, 4, 5, 6.
• However, it can be inferred that the insertion of the PleurX catheter can be done in a variety of settings, as the studies mention the use of the catheter for outpatient management of malignant pleural effusions 3, 4, 5, 6.
• The fact that the catheter can be drained at home by trained family members or caregivers suggests that the insertion procedure may not require an OR setting 3, 5.

Complications and Management

• The studies report low complication rates associated with the insertion and use of the PleurX catheter 2, 3, 4.
• Complications such as infection, blockage, and catheter dislodgement are reported, but are generally mild and can be managed 2, 3, 4.
• The use of the PleurX catheter allows for outpatient management of malignant pleural effusions, reducing the need for hospitalization 3, 4, 5, 6.