Pleural effusion is a condition of the heart that affects the lungs. The main area affected is the pleural membrane whereby the pleural fluid accumulates to an excess causing complication of the heart. The heart is the central unit of human body and with such an occurrence the patient requires treatment as soon as possible. The diagnosis of pleural effusion is detected through conduction of a chest X-ray where the patient lies facing upwards on a scanner. The scanner tends to be above the patient in order to carry out the diagnosis.
Causes and Treatment of Pleural Effusion
The diagnosis is carried to help identify the amount of fluid accumulated and the cause of the pleural effusion. The condition is determined if the fluid becomes denser than the lung and the amount of fluid above three hundred milliliters gives a signal of a pleural effusion. The causes of pleural effusion vary greatly and are categorized as exudative, transudative and other general causes which include diseases like Tuberculosis, cancer and trauma-related illness that most probably affect the heart. Moreover, careless mistakes during surgical and medical procedures are some of the general causes of pleural effusion. Exudative causes are brought about by viral infections, bacteria and cancerous cells. On the other hand, the transudative causes are as a result of cirrhosis, failure of the left ventricular and reduced osmotic pressure of the colloid, though this is less observed as a cause in most patients.
Having determined the cause of pleural effusion, the treatment is conducted on the basis of the cause of the condition. The treatment of pleural effusion is referred to as pleurodesis or thoracentesis. This basically involves the removal or drainage of the excess pleural fluid. Drainage can take place using different methods, including chest radiographs or insertions of tubes. The tubes inserted can be large chest tube or small tubes known as pig tail catheter chest tubes. The difference between chest tubes is the course of action during their insertion. Case studies have shown that the rate of failure of draining the pleural fluid using chest tubes is equal or below thirty percent. However, this percentage is valid only when the caution is taken while undertaking the procedures. The whole process involves long periods of hospitalization.
As stated above, the pig tail catheter chest tube is an insertion method that is used for drainage of the excess fluid. The method resulted as an adapted Seldinger Technique and is widely employed in most heart complications in hospitals. The method is carried out through insertion of small tubes, known as catheters, in the intercostal muscles of the pleural membrane, though the insertion does not tamper with space between the muscles. The pig tail catheter chest tube is the widely used method as opposed to the use of large chest tubes. The procedure using pig tail catheters lasts from three to fourteen days for complete drainage of the pleural fluid. This procedure usually takes place in hospitals but patients can still make daily visits to the hospital for drainage as long they receive professional nursing. This technique can drain up to five hundred milliliters of the fluid.
Complications During the Treatment Period of Pleural Effusion
There are several complications that the patients might undergo during the whole treatment period. The main and normal impediment is pain during insertion of catheter tubes as projection inside pushes and disturbs muscles that are not used to interruption. This is the common problem all the patients have to experience though they are issued with drugs to ease the twinge. However, the pain experienced during insertion of pig tail catheters is bearable as opposed to the insertion of large chest tubes. This is because large chest tubes have to get into contact with the intercostal space and muscles around the area, which is tender and sensitive. The pig tail catheter tubes never interrupt the intercostal space as they are not very invasive.
Another complication associated with the pig tail method is the blockage of catheter tubes. The tubes may be blocked by excess of pleural fluid, and if this is not noted further complications may arise, leading to the failure of drainage. In addition to this blockage, infections may come about during the pig tail procedure. These both are caused by incompetence during the insertion process. The infections include wound infections, especially if a muscle was torn, and also the infection known as pneumothorax. Pneumothorax is a condition that can be solved using the catheters. Therefore, as much as the pig tail catheter tubes are universal, the best they may bring complications if not properly inserted.
The pig tail catheter technique in some occasions fails to yield the results expected and complete drainage of pleural fluid turns out to be impossible. The main factor that contributes to the failure of the procedure is an incidence where the pleural fluid accumulates in the pleural intercostal space immediately after removal of the catheter tubes. The condition tends to recur each time an attempt to drain the fluid is made. The fluid occupies the same pleural space hence leading to the failure of the procedure. Additionally, effusions that are loculated lead to the failure of the pig tail method. The method is therefore not to be employed in such cases of loculated effusion or even in a patient with an empyema condition.
Despite the failures that may come with the pig tail catheter tubes, statistics show the reliance the method has and its success as very wide and at a rate of about eighty percent and beyond. Transudative causes of pleural effusion happen to give the most successful treatments with the method of drainage followed by tuberculosis related pleural effusion. The main merit associated with the pig tail catheters is the fact that they are safe and most patients suffering from pleural effusion choose to use the method as their mode of treatment. The method is safer due its less invasive nature of insertion hence no damage of the inner tissues and muscles may occur after the drainage. The pig tail catheter chest tube method for pleural effusion is recommended for all the patients with severe condition.
Work Cited
- Wong, C. L., Straus, S. E. & Holroyd-Leduc, J. (January 21, 2009). Does this patient have a pleural effusion? Jama – Journal of the American Medical Association, 301, 3, 309-317.
- http://www.cdc.gov/ncidod/dvbid/dengue/slideset/spanish/set1/images/pleural-effusion-index.jpg