Catheters for Pleural Effusions and Ascites Drainage
An innovative approach to home management of malignant pleural effusions and ascites drainage.
Information for Doctors and Nurses
The PLEURX Pleural Catheter and PLEURX Home Drainage Kit (Denver Biomedical, Inc.) have FDA clearance for intermittent, long-term drainage of symptomatic, recurrent, malignant pleural effusions and ascites drainage.
The devices are indicated for the palliation of dyspnea due to malignant pleural effusions and for providing pleurodesis. The most common treatment for a persistent, recurrent malignant effusions has been large-bore chest tube drainage followed with instillation of a sclerosing agent (i.e., tube thoracostomy with pleurodesis). This procedure requires hospitalization, limits patient mobility and is uncomfortable. The PLEURX catheter is a small-bore catheter; the fenestrated end is placed into the pleural space. Several inches of the mid-portion of the catheter, including the cuff, are tunneled subcutaneously. The final length of catheter and the valve remain external for patient drainage. Once the catheter is in place, fluid is evacuated form the pleural space.
The PLEURX Drainage Kit has a specially designed tip on the drainage line permitting access of the valve on the pleural catheter. Once the clamp on the drainage bottle is released, the fluid is withdrawn from the pleural space into the bottle. The patient is sent home when the physician determines the patient is stable. The effusion is drained every day or two to provide relief of dyspnea.
Based on the available published peer-reviewed medical literature and expert consultant opinion, the available medical evidence supports coverage of the PLEURX Pleural Catheter and Home Drainage Kit as an alternative to periodic hospitalizations for patients with chronic pleural effusions due to malignant disease, and for patients with chronic pleural effusions due to other, nonmalignant causes.
PLEURX Benefits
Outpatient and/or ambulatory management of intractable effusion asociated with malignancy
Drains the effusion resulting in relief of dyspnea and improved quality of life
Reduces hospitalisation
Patients and/or caregivers readily adapt to managing the effusion at home
Eliminates repeated needle insertion to perform thoracentesis
Note: PLEURX catheters can be used to deliver medication, for example, Bleomycin, into the pleural cavity. The catheter can also be used for the drainage of ascites from the abdomen.
Some references of interest
"Outpatient management of malignant pleural effusion by a chronic indwelling pleural catheter" Joe B Putnam, et al The Annals of Thoracic Surgery Vol. 69, No 2, February 2000
"Pleurx tunneled catheter in the management of malignant ascites" Howard M Richard, et al Journal of Vascular and Interventional Radiology Vol. 10, No 5, March 2001
"Management of symptomatic ascites in recurrent ovarian cancer patients using an intra-abdominal semi-permanent catheter" Tara D Iyengar & Thomas J Herzog American Journal of Hospice & Palliative Care Vol. 19, No 1, Jan/Feb 2002
"A randomised comparison of indwelling pleural catheter and Doxycycline pleurodesis in the management of malignant pleural effusions" Joe B Putnam, et al Cancer Vol. 86, No 10, Nov 15, 1999
"Use of an implantable pleural catheter for Trapped Lung Syndrome in patients with malignant pleural effusion" Grace W Pien, et al Chest Vol. 119, p. 1641-1646, June 2001
"Treatment of malignant pleural effusions with tunneled long-term drainage catheters" Jeffrey S Pollak, et al Journal of Vascular & Interventional Radiology, Vol. 12, No 2, Feb 2001
"Clinical experience with Pleurx catheters for malignant pleural effusions" W H Warren & L P Faber Chest, Oct 2000
Also available:
Instructions for Use
Patient Instructions
Training Guide for Nurses
Video or CD on Patient Education
Video or CD on Placement and Initial Drainage
For details of the contents of the catheter kits and accessories see "Procurement Information".
Information for Patients
A pleural effusion is a collection of fluid in the chest cavity (pleural space). Acsites is a collection of fluid in the abdomen. These collections of fluid can be caused by cancer, heart failure, liver disorders and many other conditions.
The symptoms of these fluid collections are shortness of breath, abdominal distension and general discomfort. In order to relieve these symptoms the fluid needs to be drained on a regular basis but due to the underlying cause, it tends to re-accumulate. The Pleurx Catheter is an innovative approach to home management of these effusions. The catheter is a short tube with drainage holes which is inserted into the chest cavity or abdomen by your doctor. The end of the catheter protrudes through the skin and has a valve that prevents leakage of fluid when not in use. This end is protected by a dressing that ensures comfort and discretion. The catheter can be placed using local anaesthetic and is a painless procedure. The fluid is drained by means of an access tube that opens the valve. This procedure can be repeated whenever necessary depending on the severity of the symptoms, usually every 2-7 days. The catheter can remain in the body for many months. If required, drainage can be performed using a drainage line attached to a vacuum bottle.
Advantages of using a Pleurx catheter
As fluid can be drained at home safely and easily it obviates the need for hospital admissions or visits to a doctor or clinic
You can decide when to drain fluid depending on your symptoms and comfort
The drainage procedure is quick and pain-free as no further injections are required
Procurement Information
PLEURX Pleural Catheter Mini Kit Catalogue No: 50-7050 NAPPI 413800-001
