Intra-pleural Irrigation

Intra-pleural Irrigation

What is intra-pleural irrigation?

This is a procedure which involves putting a volume of sterile fluid (saline) into the space between your lung and chest wall (pleural space) via your chest drain.   A volume of 250mls is attached to your chest drain and elevated on a ‘drip stand’ to allow the fluid to drain freely into your pleural space by gravity.  The fluid is left for one hour but may not take this long to be administered.  The saline bag and tubing can then be removed.  The drain is then returned to free drainage into the chest drain bottle and the chest drain observation chart is updated. 

Why do I need intra-pleural irrigation?

Pleural infection is often difficult to treat and sometimes requires additional treatment to improve pleural fluid drainage.  Standard medical management involves chest tube drainage and antibiotics.  It is considered in patients with pleural infection who may have a prolonged wait for surgery or who are deemed unsuitable for surgery.

What are the benefits of intra-pleural irrigation?

Intra-pleural irrigation is generally considered to be a safe procedure which can aid in improving pleural fluid drainage and clearing the pleural space.

What are the risks of intra-pleural irrigation?

The majority of patients undergoing intra-pleural irrigation experience no adverse events.

In some patients it may not have the desired effect in encouraging fluid drainage. 

Sometimes the fluid leaks from the chest drain site and sometimes the fluid is retained in the pleural space.  If this occurs the irrigation will be stopped.  All fluid given is recorded on the chest drain observation chart so this is monitored. 

If there was an air leak (hole) from the lung into the pleural space, the saline irrigation could seep into the lung and worsen infection.  In the majority of cases the medical team would be aware of this prior to considering this treatment.

What does the procedure involve?

Irrigation is usually prescribed three times per day for a total of nine irrigations.   The procedure is performed on the ward at the bedside (with curtains drawn for privacy).  Prior to the procedure you will be given this patient information leaflet, the procedure will be explained to you and you will be asked to sign a written consent form to ensure you are happy to have it done.

The bag of saline is attached to your chest drain via the 3-way connector and suspended on a drip stand.  The fluid is administered via gravity into your pleural space, allowing one hour for administration (may not take this long).  After one hour or sooner, the bag is removed and the chest drain allowed to drain into the chest drain bottle once more.

The volume administered is recorded on your chest drain observation chart as is the total amount of fluid drained.

What are the alternatives?

Pleural irrigation is only considered for patients who have a delay until transfer for surgery or if the surgeons feel an operation would carry too great a risk to yourself.   If you did not wish to have this procedure you would continue with standard medical treatment –  chest drain and antibiotics.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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