Pleurodesis using a chest drain
Pleurodesis is a procedure that uses medicine to seal the space between your lungs and chest wall (pleural space).
Your doctor might suggest pleurodesis if you had a collection of fluid or air in your pleural space, and this is likely to happen again.
When fluid collects in the pleural space, you usually feel short of breath (breathlessness). The aim of pleurodesis is to stop the fluid from returning and to help your breathing.
We put a tube called a chest drain into the pleural space to drain away the fluid or air that has collected.
Read more about having a chest drain.
We inject the pleurodesis medicine into the pleural space using your chest drain. The medicine seals the pleural space and stops fluid or air collecting there.
Pleural space or pleural cavity
The space between your lung and chest wall is called the pleural cavity or pleural space. It is made up of 2 thin layers (membranes). 1 layer lines the lung and the other lines the chest wall.
The 2 layers are close together. They usually have a small amount of fluid in the space between them (about 15 to 30ml).
For some people, a larger amount of fluid can collect in this space (pleural effusion). If you have pleural effusion, the lungs cannot work properly and you will be short of breath.
Benefits of pleurodesis
Pleurodesis stops the collection of fluid or air coming back in about 7 to 8 in every 10 cases.
If the fluid or air does come back, you might need to have your chest drained again. In some cases, you might have pleurodesis for a second time. If you need a second pleurodesis, the success rate is often lower.
If you have any questions or concerns, please contact the pleural team.
When the fluid has drained completely using your chest drain, you have a chest X-ray and ultrasound scan. These tests confirm that your lung has expanded again after being drained.
You have an injection of the pleurodesis medicine (usually sterile talc) into your chest through the chest drain. We usually inject this medicine as a liquid.
After having the medicine, your chest drain might be closed for 1 to 2 hours. We then open your chest drain again. This drains away any more fluid or air that has collected.
We might leave the drain in your chest for a few days or remove it straight away. When we remove the drain, the pleurodesis procedure is complete.
You might need a single stitch to close the area where we put in the chest drain. The stitch is removed after 7 days.
Pleurodesis can cause some pain. We give you painkillers to help with this. It is still quite common to feel some discomfort during the procedure. If this happens, please tell the doctor or nurse. They can give you more painkillers.
Most people have pleurodesis without any major problems. However, like all medical treatments, the procedure does have some risks.
Some people have a high temperature for 1 to 2 days after the procedure. You can usually control this with paracetamol.
There is some risk of infection with all treatments that involve a tube in the chest. About 2 in every 100 people who have pleurodesis get an infection. If this does happen, the infection can usually be treated with antibiotics.
Contact your pleural team or go to A&E if:
you have any signs of an infection, such as:
- pain around the chest drain
- liquid or pus (a thick, yellowish liquid) in the area
- a high temperature (fever)
Other treatment options
There are some other treatment options to pleurodesis using your chest drain.
- Thoracocentesis. We can drain the fluid with a very small tube over a short time. This procedure is called thoracocentesis. However, the fluid is likely to come back and you then need more treatment.
- Thoracoscopy. You can have a thoracoscopy, where the doctor puts a camera into your pleural space and then gives you the pleurodesis medicine. You stay in hospital with the tube in for up to 3 days after this procedure. If your lung does not expand again after this time, the pleurodesis has not worked. This happens to about 3 in every 10 people who have the procedure.
- Indwelling pleural catheter: You can have a special tube called an indwelling pleural catheter (IPC) put into your chest. This is a permanent tube that we can use to drain the fluid as it collects.
Giving your permission (consent)
We want to involve you in decisions about your care and treatment. If you decide to have pleurodesis, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.
If you would like more information about our consent process, please speak to a member of staff caring for you.
Resource number: 4251/VER3
Last reviewed: October 2021
Next review date: October 2024