According to statistics, the tendency to increase respiratory diseases is growing every year. In Russia alone today, about 5 million people suffer from pathologies of the bronchopulmonary system. Among the diseases, chronic bronchitis, pneumonia, asthma, pleurisy, COPD (chronic obstructive pulmonary disease) predominate. What follows is tuberculosis. The incidence of lung cancer is growing, which is leading among all other oncologies. The main contingent of patients is smokers with experience 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 vesicular constituents of the lungs. Oxygen is captured from the incoming air, and carbon dioxide is released. This is the basic physiological process that provides the body with oxygen.
With violations of air exchange in the tissues, the permeability of capillaries increases or the integrity of the vessels in general is violated. Through their walls, fluid begins to leak, which can fill the alveoli. It accumulates more often not in the lung, but in the pleural cavity, between the pleural sheets.
To ensure a normal lung excursion, a healthy person always has about 2 ml of serous fluid in the pleural region. If its volume exceeded 10 ml, removal is required.
Causes
One of the reasons is a malfunction in the lymph system, which causes edema. Fluid accumulation most often occurs with:
- heart diseases - arrhythmias, heart defects, heart attacks, heart failure;
- liver diseases - its insufficiency or cirrhosis;
- diabetes mellitus;
- renal failure;
- pneumonia - pneumonia, tuberculosis, pleurisy;
- lung cancer
- COPD
- pulmonary edema;
- head and chest injuries (pneumothorax).
Fluid in the elderly
In addition to the above pathologies, in old age, fluid in the lungs is possible after prolonged use of aspirin, which is used as an analgesic. Also, physical inactivity can become a cause, since the elderly, for various reasons, move little. Pulmonary circulation is impaired.
Fluid composition
The composition will be different for various pathologies. Accumulation of serous fluid sometimes with impurities of the blood happens with lung cancer, when malignant pleurisy develops. Purulent exudate is observed in acute inflammatory process in the lungs.
Any liquid composition is not the norm, and measures should be urgent. Water in the pleura is not as dangerous as edema.
Signs
During sleep, attacks of shortness of breath appear, which indicates respiratory failure, the skin becomes cyanotic. A wet cough with pink foam is observed, later attacks of suffocation appear in the afternoon. This indicates pulmonary edema. Such symptoms require pumping fluid from the lungs.
Symptoms
Clinical manifestations depend on the amount of accumulated exudate:
- Shortness of breath is the first symptom of fluid accumulation. This occurs because, with gas exchange disorders, the lungs begin to work intensely to increase oxygen supply.
- Breathing quickens and worsens, 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 in peace and in a dream.
- Cough is a later symptom. The condition of the lungs has already worsened. It is intermittent, with a large discharge of sputum. This is accompanied by dizziness, fainting.
- Pain in the chest - at rest it is tolerant, aching, worse with coughing and movements. 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 triangle turns blue.
- Deterioration of general well-being - lethargy, loss of strength, weakness, which are combined with anxiety, appear.
- Respiratory failure - in the form of asthma attacks.
- Something gurgles in the lungs - it is felt by the patient himself when turning the body.
Additional symptoms are severe chills, a feeling of cold, accompanied by numbness of the arms and legs. These manifestations are more likely to appear in the morning. During the day, symptoms appear after any exertion - stress, movement, hypothermia.
Diagnostics
To find out if pumping fluid from the lungs is necessary, 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:
- heart disease test;
- blood biochemistry;
- coagulation determination;
- determination of pressure in the lungs.
After establishing the etiology of the appearance of fluid in the lungs, methods for better pumping fluid out of the lungs and getting rid of it are determined.
Treatment
The tactics of treatment depend on the results obtained. Unfortunately, only a small part of pulmonary pathologies is treated with medication. Many require surgical intervention. Such pathologies include:
- congenital malformations;
- lung tumors;
- cysts;
- caverns during the tuboprocess;
- 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 for pumping fluid from the lungs are performed only in specialized departments of thoracic (thoracic) surgery by qualified specialists. Ambulance workers do not do this.
Pleurocentesis
When and how is pumping out fluid from the lungs? Transudate, which is caused by a non-infectious nature, is usually removed. 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 cured before the procedure. If even after this 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 name of pumping fluid from the lungs? Pleurocentesis or thoracocentesis. During these procedures, mechanical removal of fluid occurs. Anesthesia is performed by local anesthesia. Special preparation of the patient is not required. Usually, the doctor tries before stabilization to stabilize the state of the cardiovascular and respiratory systems with the help of symptomatic therapy. The patient is in a sitting position, leaning forward slightly, puts his hands on a special table or leads behind his head.
How is the procedure for pumping fluid from the lungs? First, with the help of ultrasound or X-ray, the location of the exudate accumulation is determined, then a local anesthetic is administered and an novocaine injection is made.
The skin is rubbed with alcohol, and the doctor in the area under the scapula (in the middle between the middle 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 punctures the pleural cavity. In this way, tissue infiltration with novocaine or lidocaine is performed. Actions should be extremely accurate, because there is the possibility of damage to the neurovascular bundle.
The depth must also be accurate, so the syringe plunger is pulled back periodically for inspection. If the needle is inserted too deep, the lung parenchyma can be damaged. The needle is inserted to the sensation of failure - at this depth of penetration is measured. The upper membrane of the lung (pleura) is more dense than its contents.
Then the needle is removed from anesthesia, and a thick needle is inserted for thoracocentesis (to a measured depth). Through the adapter, the needle is connected to the pipe of the electric pump. Part of the effusion goes to the laboratory for analysis, the adapter is transferred to the suction and the effusion is evacuated. A device for pumping fluid from the lungs is an electric suction device or a drainage-suction device. In the absence of an electric suction, a Janet syringe is used.
The fluid is pumped out (aspiration of fluid from the pleura), catheters are inserted, through which exudate is released for some time. Pumping fluid from the lungs does not take much time - about 15 minutes. After this, the catheters are removed and the puncture site is again lubricated with alcohol. A sterile dressing is applied. Sometimes, if necessary, the catheters are left. Conduct control radiography.
The pumping procedure must be carried out exclusively under sterile conditions. Therefore, pumping fluid from the lungs at home is not carried out. Depending on the purpose, aspiration may be therapeutic or diagnostic.
It is possible to pump out for 1 time no more than 1 liter of liquid. If the volume is exceeded, complications arise, even a fatal outcome is possible. With a gradual decrease in the liquid level during its pumping, the patient becomes clearly easier.
After pumping fluid from the lungs, it can collect again, since the main cause of the disease during the procedure is not eliminated, there are no guarantees for complete primary removal. For etiotropic treatment using other methods. Repeated pleurocentesis is very difficult for patients, because there are already adhesions that complicate the operation.
The weakening of the immune system always contributes to the re-accumulation of fluid. At risk are patients after 60 years. Normalizing fluid levels in the lungs often requires treatment of other organs, judging by the list of diseases. Artificial elimination of exudate from the lungs by puncture - this is how it is called pumping fluid from the lungs. The most radical way is bypass surgery. When a shunt is established, it transfers the accumulating fluid from the pleural cavity to the abdominal.
With non-surgical pathology, competent treatment of the underlying disease allows the amount of fluid to normalize independently - 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 affect the cause of the pathology, pleurodesis is used.
How many times can I pump fluid from my 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
A fairly popular procedure in pulmonology. Pleurodesis is also a surgical operation, but with the opposite 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 ("Embihin" or "Cisplatin"), immunomodulators ("Interleukin"), antimicrobial drugs ("Tetracycline") and anti-tuberculosis drugs. Such treatment is quite effective, because it acts directly at the site of the pathology. In other words, pleurodesis is the treatment after pumping fluid from the lungs.
Recovery Predictions
The chances of recovery depend on the etiology of the disease. A negative prognosis exists only for cancer. Moreover, it does not matter at what stage the accumulated fluid in the lungs is detected. With other pathologies, if treatment is started on time, the prognosis is favorable, the functioning of the pulmonary system is fully restored.
Self-treatment with alternative methods is excluded - not a single patient with this method has been cured. Precious time is lost, and the consequences are most deplorable. A person may die due to respiratory failure.
Consequences of fluid accumulation
With a small amount of fluid accumulation, significant damage to the body is not caused, especially in case of timely medical attention. But with chronic pulmonary pathologies, the elastic tissue of the lungs is replaced by fibrous, which worsens the already impaired gas exchange and leads to pronounced oxygen starvation. With a lack of oxygen, the brain and central nervous system suffer. The outcome is often fatal.
Oncology lung fluid
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, the accumulation, unfortunately, indicates a critical depletion of the body and is already observed at the last stages of the disease. Edema often occurs amid a decrease in protein levels - a necessary consequence of cancer progression. In this case, one should not expect a good result from treatment.