According to statistics, the trend towards an increase in respiratory diseases is growing every year. Only in Russia today about 5 million people suffer from pathologies of the bronchopulmonary system. Chronic bronchitis, pneumonia, asthma, pleurisy, COPD (chronic obstructive pulmonary disease) predominate among diseases. Next comes tuberculosis. The incidence of lung cancer is growing, which is the leader among all other oncologies. The main contingent of patients are long-term smokers and residents of large industrial centers.
What is fluid in the lungs
Gas exchange in human blood occurs in the alveoli. This is a lot of bubble components of the lungs. Oxygen is taken from the incoming air and carbon dioxide is released. This is a basic physiological process that provides the body with oxygen.
In case of violations of air exchange intissues, the permeability of capillaries increases or the integrity of the vessels in general is violated. Liquid begins to seep through their walls, which can fill the alveoli. It accumulates more often not in the lung itself, but in the pleural cavity, between the pleural sheets.
To ensure normal lung excursion, a he althy person always has about 2 ml of serous fluid in the pleural region. If its volume exceeded 10 ml, removal is required.
Reasons
One of the reasons is a malfunction in the lymph system, which causes swelling. Fluid accumulation most often occurs when:
- heart disease - arrhythmias, heart defects, heart attacks, heart failure;
- liver disease - liver failure or cirrhosis;
- diabetes;
- kidney failure;
- inflammation in the lungs - pneumonia, tuberculosis, pleurisy;
- lung cancer;
- COPD;
- pulmonary edema;
- trauma to the head and chest (pneumothorax).
Fluid in the elderly
In addition to the above pathologies, in the elderly, fluid in the lungs is possible after long-term use of aspirin, which is used as an analgesic. Physical inactivity can also be the cause, since the elderly, for various reasons, move little. Pulmonary circulation is thus disturbed.
Composition of liquid
The composition will be different for different pathologies. The accumulation of serous fluid, sometimes with blood impurities, occurs with lung cancer, when it developsmalignant pleurisy. Purulent exudate is observed in acute inflammation in the lungs.
Any composition of the liquid is not the norm, and measures must be urgent. Water in the pleura is not as dangerous as swelling.
Signs
During sleep there are attacks of shortness of breath, which indicates respiratory failure, the skin becomes cyanotic. There is a wet cough with pink foam, later attacks of suffocation appear during the day. This is indicative of pulmonary edema. Such symptoms require fluid to be pumped out of the lungs.
Symptoms
Clinical manifestations depend on the amount of accumulated exudate:
- Shortness of breath is the first symptom of fluid accumulation. It occurs because when gas exchange is disturbed, the lungs begin to work hard to increase the supply of oxygen.
- Respiration becomes more frequent and heavier, which, as the process progresses, worsens the patient's condition, and he begins to suffocate. If the disease has a slow course, shortness of breath occurs suddenly, sometimes against the background of fatigue. She appears already both at rest and in a dream.
- Cough is a later symptom. The condition of the lungs has already deteriorated. It is intermittent, with a lot of sputum. This is accompanied by dizziness, fainting.
- Chest pain - at rest it is tolerable, aching, aggravated by coughing and movement. The symptom is not always present, it is localized more often in the lower parts of the chest.
- Change in skin color - it becomes pale due to hypoxia, and the nasolabial triangleturning blue.
- Deterioration of general well-being - lethargy, loss of strength, weakness appear, which are combined with anxiety.
- Respiratory failure - in the form of asthma attacks.
- There is something gurgling in the lungs - it is felt by the patient himself when turning the torso.
Additional symptoms are severe chills, a feeling of cold, accompanied by numbness of the hands and feet. These manifestations are more likely to appear in the morning. During the day, symptoms appear after any exertion - stress, movement, hypothermia.
Diagnosis
To find out if it is necessary to pump out fluid from the lungs, a diagnosis should be made, which includes the following procedures:
- X-ray.
- Ultrasound (ultrasonography) - will show the amount of fluid and the place of accumulation.
- Blood gas analysis.
To determine the cause of the pathology, carry out:
- study for heart disease;
- blood biochemistry;
- definition of coagulability;
- determination of pressure in the lungs.
After establishing the etiology of the appearance of fluid in the lungs, determine the best ways to pump fluid from the lungs and get rid of it.
Treatment
Treatment tactics depend on the results obtained. Unfortunately, only a small part of pulmonary pathologies is treated with medication. Many require surgery. For such pathologiesinclude:
- congenital anomalies;
- lung tumors;
- cysts;
- caverns during tubing;
- parasites in the lungs (echinococcus, alveococcus);
- abscess and pulmonary infarction;
- atelectasis and bronchiectasis in the lungs;
- injuries with foreign bodies in the lungs;
- bronchial fistulas;
- pneumonia;
- pleurisy.
All operations to pump fluid from the lungs are performed only in specialized departments of thoracic (thoracic) surgery by qualified specialists. Ambulance workers don't do this.
Pleurocentesis
When and how is fluid pumped out of the lungs? Usually, a transudate is removed, which is caused by a non-infectious nature. If the pathology is associated with inflammation and there is an admixture of pus in it, then this is exudate.
In such cases, inflammation should be treated before the procedure. If after that the liquid remains, it is removed. It should be borne in mind that pumping occurs from the pleural cavity; it is impossible to do this by suction. In these cases (pulmonary edema, for example), medical treatment.
What is the pumping of fluid from the lungs called? Pleurocentesis or thoracocentesis. During these procedures, the mechanical removal of fluid occurs. Pain relief is done with local anesthesia. Special preparation of the patient is not required. Usually, the doctor tries to stabilize the state of the cardiovascular and respiratory systems before centesis with the help of symptomatic therapy. Sickis in a sitting position, leaning slightly forward, puts his hands on a special table or winds up behind his head.
How is the procedure for pumping fluid out of the lungs? First, using an ultrasound or x-ray, the location of the accumulation of exudate is determined, then a local anesthetic is injected and novocaine is injected.
The skin is wiped with alcohol, and the doctor in the area under the scapula (in the middle between the mid- and posterior axillary line) strictly along the upper edge of the rib between the 6th and 7th intercostal space with a thin injection needle carefully pierces the pleural cavity. Thus, tissues are infiltrated with novocaine or lidocaine. Actions must be extremely careful, because there is a possibility of damaging the neurovascular bundle.
The depth must also be accurate, so periodically the syringe plunger is pulled back to check. If the needle is inserted too deep, the lung parenchyma may be damaged. The needle is inserted until it feels like a failure - this is where the penetration depth is measured. The upper lining of the lung (pleura) is denser than its contents.
Next, the anesthesia needle is removed, and a thick needle for thoracentesis is inserted (to a measured depth). Through an adapter, the needle is connected to the electric suction pipe. Part of the effusion goes to the laboratory for analysis, the adapter is transferred to suction and the effusion is evacuated. The device for pumping fluid out of the lungs is an electric suction device or a drainage-suction device. In the absence of an electric suction, Janet's syringe is used.
The fluid is pumped out (fluid aspiration from the pleura), catheters are inserted through which for some timeexudate is released. Pumping out fluid from the lungs does not take much time - about 15 minutes. After that, the catheters are removed and the puncture site is again smeared with alcohol. A sterile dressing is applied. Sometimes, if necessary, catheters are left. A control X-ray is taken.
The evacuation procedure must be performed exclusively under sterile conditions. Therefore, pumping fluid from the lungs at home is not carried out. Depending on the purpose, aspiration can be therapeutic or diagnostic.
You can pump out no more than 1 liter of liquid at a time. If the volume is exceeded, complications arise, even death is possible. With a gradual decrease in the level of fluid in the process of pumping it out, the patient becomes clearly better.
After pumping fluid from the lungs, it can be collected again, since the main cause of the disease itself is not eliminated during the procedure, there are no guarantees for complete primary removal. For etiotropic treatment, other methods are used. Repeated thoracentesis is very difficult for patients, because there are already adhesions that complicate the operation.
Weakened immunity always contributes to the re-accumulation of fluid. Patients over 60 years of age are at risk. Normalization of fluid levels in the lungs often requires treatment of other organs, judging by the list of diseases. The artificial removal of exudate from the lungs by puncturing them is another name for pumping fluid out of the lungs. The most radical way is shunting. When a shunt is installed, the accumulating fluid from the pleural cavity is transferred toabdominal.
In case of non-surgical pathology, competent treatment of the underlying disease allows the amount of fluid to normalize on its own - this option is not excluded. But this does not apply to severe pathologies. Thus, the consequences of pumping fluid from the lungs are a short-term improvement in the patient's well-being. To influence the cause of the pathology, pleurodesis is used.
How many times can fluid be pumped out of the lungs
The number of repetitions of the procedure is determined by the doctor. Sometimes the procedure is carried out every other day. It is important to identify the cause of fluid accumulation and eliminate it.
Pleurodesis
Quite a popular procedure in pulmonology. Pleurodesis is also a surgical operation, but with the reverse algorithm: the pleural cavity is filled with special therapeutic agents to prevent the re-formation of fluid.
The drugs used for this are very different: sclerosing - cytostatics ("Embikhin" or "Cisplatin"), immunomodulators ("Interleukin"), antimicrobials ("Tetracycline") and anti-tuberculosis. Such treatment is quite effective, because it acts directly at the site of the pathology. In other words, pleurodesis is the treatment after pumping out fluid from the lungs.
Recovery forecasts
The chances of recovery depend on the etiology of the disease. A negative prognosis exists only for oncological diseases. At the same time, it does not matter at what stage the accumulatedfluid in the lungs. In other pathologies, if treatment is started on time, the prognosis is favorable, the functioning of the pulmonary system is fully restored.
Self-therapy with folk methods is excluded - not a single patient has been cured by this method yet. Precious time is lost, and the consequences are the most deplorable. A person can die due to respiratory failure.
Consequences of fluid accumulation
With a small amount of fluid accumulation, significant harm to the body is not caused, especially in the case of a timely visit to the doctor. But in chronic pulmonary pathologies, the elastic tissue of the lungs is replaced by fibrous tissue, which worsens the already disturbed gas exchange and leads to severe oxygen starvation. With a lack of oxygen, the brain and central nervous system suffer. The outcome is often fatal.
Lung fluid in oncology
Oncology is becoming the most dangerous cause of accumulation of exudate in the lungs. Pumping fluid from the lungs in cancer is practiced in the initial stages. In cancer patients with lung cancer, accumulation, unfortunately, indicates a critical depletion of the body and is observed already in the last stages of the disease. Edema often occurs against the background of a decrease in protein levels - a necessary consequence of the progression of cancer. In this case, you should not expect a good result from treatment.
