The pleura is the thinnest serous membrane that envelops the lungs of a person, and consists of external and internal sheets. The term "accumulation of fluid in the lungs" refers to the exudate that forms in the pleural cavity. Normally, there should be about 2 ml of this liquid.
It is extremely important for an optimal breathing process. But for certain reasons, excess fluid may accumulate here, which will be discussed below. As well as how to pump fluid out of the lungs in newborns and adults using drainage.
Causes of disease
Pleurisy in most cases occurs as a result of respiratory diseases. So what kind of disease is it to pump fluid out of the lungs in which it is vital? So, note the following reasons for this pathological condition:
- lung disease;
- rheumatism;
- pneumonia andhis tissues, arising from developing pneumonia;
- oncological diseases;
- defective work of the cardiac system;
- chest injury.
The body of the pleural cavity consists of very small fibers of the lymphatic system, as well as a small amount of interstitial fluid. Excessive exudate will accumulate in the lungs due to increased vascular permeability as well as mechanical integrity failure.
Permeability of pleural vessels may also increase due to exposure to an autoimmune or infectious process. As a result, blood proteins and its plasma can seep into the cavity, accumulating below.
Types of liquid
The accumulation of excess exudate in the lungs can provoke the development of increased swelling. Depending on the form, blood from a vein, pus, and decay products are sometimes mixed with the liquid.
Pleuritis can be complicated by respiratory dysfunction. Doctors distinguish the following types of the disease:
- subacute;
- spicy;
- protracted;
- lightning fast.
When a patient develops edema in an acute form, pain in the sternum is noted, as well as a feeling of squeezing. There may also be shortness of breath and rapid breathing. The patient sweats a lot and profusely. The color of the skin becomes pale and somewhat cyanotic. In this condition, the patient may experience a wet cough, wheezing, as well as the release of pinkish sputum with foam, which in critical cases canalso exit through the nose.
The most common manifestation of edema in acute form is intermittent, rapid, bubbling and loud breathing. The patient, due to the rapidly developing lack of air, may also experience panic attacks. Even a short-term loss of consciousness is possible, as well as a violation of the working capacity of the nervous system. The more swelling increases, the faster the pulse will weaken and the pressure will decrease.
When a lightning-fast form is detected, the above manifestations will appear very quickly. Without emergency medical attention, swelling can be fatal.
Danger of exudate accumulation
Extremely dangerous will be the accumulation of fluid in case of detection of purulent pleurisy in a patient. In this situation, pulmonary edema can turn into tissue death, gangrene and a more complex form, even chronic.
In case of untimely treatment, a breakthrough of fluid with pus from the pleura is possible, in which a fistula is formed. If exudate enters the body, sepsis can form. In this state, the infection penetrates the lymphatic system, as a result of which a focus with a large amount of pus is formed in various organs.
Indications for surgery
The main indications for drainage of the pleural cavity with constant monitoring by performing ultrasound are the following factors:
- availability of ventilators;
- diseases of the blood system;
- limited pleurisy;
- minimum effusion;
- the presence of diseases of the central nervous system and lungs of a congenital nature.
Extract fluid from the lungs with pleurisy only if indicated, and also in the absence of contraindications.
Performing drainage
This procedure must be performed to remove exudate, air, blood from the pleura. In addition, this method is used to expand the lungs and other conditions that can lead to hemodynamic disorders. It is very important to drain as quickly as possible so that less air enters the sternum.
Drainage Methods
Depending on the identified pathological condition, the doctor may prescribe a special method for pumping fluid from the lungs from edema. With the right method chosen, the effect of the operation will be significantly increased.
The vacuum method consists of using a hermetically sealed bottle of very hot water. It is connected to a tube for drainage, and as the water cools, fluid accumulations will come out of the pleura. This method makes it possible to remove about 80 ml of pus.
The vacuum method of the closed type involves the use of a Janet syringe, as well as a sealed container. Air or liquid is pumped out by this device. A special tube is connected to the container, after which vacuum pumping is performed in the pleura area. It is important that the vessel is completely sealed.
Subbotin's method. In this case, a pair of vessels is used, which are fixed one above the other. Between themthere must be a connecting tube of increased density. In the first vessel, located on top, there should always be water, and in the second (lower) there should be nothing. The liquid gradually overflows from above into the lower vessel, thereby creating a vacuum.
Active aspiration is the most indicative method, involving the use of an electronic or water jet type pump. The effect of this procedure is to pump out the fluid and accelerate the contraction of the resulting wound.
The method of drainage of the pleural area should be chosen exclusively by the attending physician, taking into account the existing characteristics of the patient's body, the stage of the disease, as well as the necessary equipment. It is important to have a professional drain the fluid.
How drainage works
This procedure is carried out only with the help of an assistant, since the doctor will not be able to perform the examination and perform the procedure himself. For drainage, special containers, purified water, thoracic catheters, a needle holder, two clamps, scissors, a scalpel, two packages of special silk threads, special needles with pavilions, a local anesthetic, and a ten-millimeter syringe are used. Sterile dressing supplies will also be needed.
Before the procedure, the patient should be properly prepared. The first condition is an empty stomach: a person is forbidden to eat 12 hours before the operation. When the doctor performs a general examination, it will be necessary to undergo the following examinations: CT scan or X-ray, ultrasound, CBC with the detection of platelets, a blood group test andAIDS.
The patient is advised not to take anticoagulant drugs before performing a relatively rare surgery.
This procedure begins with the location of the patient: he must be placed on a he althy side, raise his hand from the side of the manipulation. The catheter must be correctly inserted into the peripheral vein. Sometimes drainage can be done in a seated position with the person slightly tilted forward.
After that, the doctor must determine the place where the drain will be inserted. The main condition is to carefully insert it from above along the edge of the ribs. The doctor marks the place of the future puncture with a special marker, after which this place is treated with an anesthetic. If the patient has disorders of the nervous system, the surgeon may prescribe general anesthesia.
Draining procedure
To remove excessive exudate from the pleura, especially in the presence of a complex form of the disease, pumping out excess fluid from the lungs is used. In the place under the scapula, the surgeon performs a puncture with a special needle, making a sampling of pus. For the treatment of a cancer patient, it is necessary to use the method of filling the pleural cavity with effective antitumor substances. The most radical way is shunting. The shunt will transfer fluid into the abdominal cavity from the pleural cavity.
Exudate is removed artificially by performing a lung puncture according to the following technique:
- determined by its location using ultrasound;
- the patient is injected locally according to the actionanesthetic, the person is moved to a sitting position and slightly tilted forward;
- a needle is inserted into the intercostal region from the back and fluid is pumped out;
- next, the surgeon connects the catheters, through which the exudate goes further.
Pull fluid out of lungs: what next?
When the drainage is complete and the test results confirm that there is no trace of fluid in the pleura, the doctor may decide to remove the drainage tube
First, the bandage is removed, the sutures are loosened, and then the drainage is removed. The tube must be removed without excessive loosening, in one motion. The patient is advised to hold their breath for a while.
The resulting wound must be sutured and bandaged. Bandaging should be performed daily, while the doctor should assess the patient's well-being, as well as the condition of the sutures. If after the procedure there is no recurrence, you can remove them on the 10th day.
Recurrence may be pneumothorax or hydrothorax, empyema, emphysema, pulmonary edema, possible bleeding. In order to identify complications in time, and also, if possible, eliminate them, the patient needs to go to the hospital.
Result
Pumping out pus from the pleural area is a vital procedure that must be performed quickly and, most importantly, efficiently. The normal life of the patient will directly depend on the correctness of its implementation. And the way fluid is pumped out of the lungs in case of cancer, edema or other diseases affects the furtherthe course of the disease.
