Catheter System Drains Recurrent Pleural Effusions

A novel catheter system enables patients to drain pleural fluid at home, instead of requiring them to return to the hospital for thoracentesis.

The PleurX catheter system consists of a catheter that is inserted in the chest wall for draining pleural effusions, or into the abdomen for malignant ascites, and proprietary drainage bottles. To drain pleural fluids, the free end of the catheter is connected to the drainage line on the external vacuum bottle, which then automatically draws out the fluid by pressure differential; a roller clamp controls flow on the drainage line. The kit also features a self-adhesive dressing used to maintain the catheter discrete and clean.

The PleurX catheter can also be used in place of a chest tube for the delivery of talc or bleomycin for chemical pleurodesis, offering an additional treatment option. Potential complications can include pneumothorax, re-expansion pulmonary edema, hypotension, circulatory collapse, and infection of the pleural space. It is also not recommended to drain more than 1,000 mL of fluid at any one time. The PleurX catheter system is a product of BD, formerly known as Becton Dickinson, and has been approved by the U.S. Food and Drug Administration (FDA).

“BD can provide patients who suffer from recurrent pleural effusions due to congestive heart failure and other non-malignant recurrent pleural effusion etiologies with an option to manage their symptoms from the comfort of their home,” said Jim Leitl, worldwide vice president and general manager for interventional specialties at BD. “The system helps patients take control of their therapy by enabling them to manage fluid from pleural effusions outside of the hospital. Patients now have the option to potentially avoid the mental and physical toll of undergoing an additional hospital procedure.”

“Our research found that the PleurX catheter provided palliation of congestive heart failure patients' pleural effusions and freedom from re-intervention equal to that of talc pleurodesis using thoracoscopy, while resulting in a shorter mean length of hospital stay,” said Richard Freeman, MD, regional chief medical officer of St. Vincent Indianapolis. “Lower rates of operative morbidity and readmission related to the pleural effusion were also seen in the PleurX catheter treatment group.”

Pleural effusion results in an excessive amount of fluid buildup in the space between the layers of pleura that surround the lung. The fluid may be categorized as either transudate, which is usually composed of ultrafiltrates of plasma resulting from an imbalance in vascular hydrostatic and oncotic forces in the chest (such as in heart failure or cirrhosis); or as exudate, which is typically produced by inflammatory conditions (such as lung infection or a malignancy). Exudative pleural effusions are usually more serious and difficult to treat.