Pleura is the thinnest serous membrane that envelops the human lungs, and consists of external and internal leaves. By the term “fluid accumulation in the lungs” is meant the exudate that forms in the pleural cavity. Normally there should be approximately 2 ml of this liquid.
It is extremely important to ensure an optimal respiratory process. But for certain reasons, excess fluid may be accumulated here, as will be described below. As well as how to pump fluid from the lungs in newborns and adults using drainage.
Causes of the disease
Pleurisy in most cases occurs as a result of respiratory diseases. So what kind of illness, pumping fluid from the lungs in which it is vital? So, the following reasons for this pathological condition are noted:
- lung diseases
- rheumatism;
- inflammation of the lungs and its tissues arising from developing pneumonia;
- oncological diseases;
- inferior work of the heart 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 intercellular fluid. Excessive exudate will accumulate in the lungs due to increased vascular permeability, as well as mechanical holistic impairment.
The permeability of the pleural vessels may also increase due to exposure to an autoimmune or infectious process. Blood proteins and plasma as a result of this can leak into the cavity, accumulating below.
Types of fluid
The accumulation of excessive exudate in the lungs can provoke the development of increased swelling. Depending on the form, blood from a vein, pus, and also decay products are sometimes mixed with a liquid.
Pleurisy can be complicated by respiratory dysfunction. Doctors distinguish the following types of disease:
- subacute;
- spicy;
- protracted;
- lightning fast.
If the patient has edema in an acute form, pain in the sternum is noted, as well as a feeling of compression. Dyspnea may also begin and breathing quicker. The patient sweats a lot and sweats profusely. Skin color 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 can also come out through the nose.
The most common manifestation of edema in acute form is intermittent, rapid, bubbling and loud breathing. A patient may also experience panic attacks due to rapidly developing air deficiency. Even a short-term loss of consciousness, as well as impaired performance of the nervous system. The greater the swelling will increase, the faster the pulse will weaken and the pressure will decrease.
When revealing a fulminant form, the above manifestations will manifest themselves very quickly. Without emergency medical care, edema can be fatal.
The danger of accumulation of exudate
Extremely dangerous will be the accumulation of fluid in the event of purulent pleurisy in a patient. In this situation, pulmonary edema can go 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. When exudate enters the body, sepsis may form. In this condition, the infection penetrates the lymphatic system, as a result of which a lesion with a large amount of pus forms in different organs.
Indications for surgery
The main indications for conducting drainage of the pleural cavity with constant monitoring by ultrasound are the following factors:
- the presence of mechanical ventilation;
- blood system diseases;
- limited pleurisy;
- minimum amount of effusion;
- the presence of diseases of the central nervous system and lungs of an innate nature.
Pump out fluid from the lungs with pleurisy only if there is evidence, as well as the absence of contraindications.
Drainage
This procedure should be performed to remove exudate, air, blood from the pleura. In addition, this method is used to straighten 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 how to pump fluid from the lungs from edema. With the right method, the effect of the operation will be significantly increased.
The vacuum method is to use a hermetically sealed bottle with very hot water. It is connected to a drainage tube, and as the water cools, pleural fluid will exit the pleura. This method makes it possible to remove about 80 ml of pus.
The closed-type vacuum method involves the use of a Janet syringe, as well as sealed containers. Pumping out air or liquid is carried out by this device. A special tube is connected to the tank, after which vacuum pumping is performed in the pleural region. It is important that the vessel is completely sealed.
Subbotin's way. In this case, a pair of vessels is used that are fixed on top of each other. Between them there should be a connecting tube of increased density. In the first vessel, located above, there should always be water, and in the second (lower) there should be nothing. The liquid is gradually poured 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 fluid pumping and accelerated contraction of the resulting wound.
The method of drainage of the pleural region 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 that a professional pump out the fluid.
How is drainage performed?
This procedure is carried out only with the help of an assistant, since the doctor will not be able to perform the study and the procedure. 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 dressings 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 food 12 hours before surgery. When the doctor performs a general examination, it will be necessary to undergo the following examinations: CT or X-ray, ultrasound, UAC with platelet detection, blood type analysis and AIDS.
Before performing a relatively rarely used surgical operation, the patient is not recommended to take anticoagulant drugs.
This procedure begins with the location of the patient: it must be placed on a healthy side, raise your hand from the side of the manipulation. The catheter must be inserted correctly into the peripheral vein. Sometimes drainage can be carried out in a sitting position, slightly tilting the person forward.
After this, the doctor must determine the place where the drainage will be introduced. The main condition is to carefully enter it from above along the edge of the ribs. The doctor designates 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.
Liquid Pumping Procedure
In order to remove excessive exudate from the pleural region, especially in the presence of a complex form of the disease, pumping out excess fluid from the lungs is used. In place under the scapula, the surgeon performs a puncture with a special needle, producing a collection of pus. To treat a cancer patient, you need to use the method of filling the pleural cavity with effective antitumor substances. The most radical way is bypass surgery. A shunt will transfer fluid into the abdominal cavity from the pleural.
The exudate is excreted artificially by performing a puncture of the lung using the following technique:
- its location is determined using ultrasound;
- a local anesthetic is administered to the patient, the person is transferred to a sitting position and tilted forward a little;
- a needle is inserted into the intercostal region from the back and fluid is pumped out;
- then the surgeon connects the catheters, through which the exudate goes further.
Pumped fluid from the lungs: what's next?
When the drainage is complete and the test results confirm the absence of traces of fluid in the pleura, the doctor may decide to remove the drainage tube
First, remove the bandage, loosen the seams, and then remove the drainage. The tube must be removed without undue loosening, in one motion. The patient is recommended to hold his breath for a while.
The resulting wound must be sutured and a bandage applied to it. Bandaging should be performed daily, while the doctor must assess the well-being of the patient, as well as the condition of the sutures. If there is no relapse after the procedure, you can remove them even for 10 days.
A relapse can be pneumothorax or hydrothorax, empyema, emphysema, pulmonary edema, bleeding is possible. In order to identify complications in time, and if possible, eliminate them, the patient needs to go to hospital.
Total
Pumping pus from the pleural region is a vital procedure that must be performed quickly and, most importantly, efficiently. The normal functioning of the patient will directly depend on the correctness of its implementation. And the way fluid is pumped out of the lungs with cancer, edema, or other diseases affects the course of the disease.