Pleural Disorders Treatment

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How your pleural disorder is treated depends on what type of pleural disorder you have and how severe it is. Some pleural disorders go away without treatment. Others will require a procedure to remove air, fluid, or other material from the pleural space. The goal of treatment is to relieve symptoms and treat the underlying condition.

Your healthcare provider may recommend medicine to treat symptoms or causes of your pleural disorder.

• Antibiotics, antifungals, or antiparasitic medicines treat infections in the pleural space or in the lung.
• Corticosteroids reduce inflammation. Corticosteroids can have serious side effects with long-term use.
• Morphine in low doses is used to treat chronic (long-term) shortness of breath. This medicine has a risk of addiction.
• Nonsteroidal anti-inflammatory drugs such as ibuprofen help reduce pain and inflammation.

Your doctor may perform one or more procedures to treat a pleural disorder. Many of these procedures are performed using ultrasound.

• Chest tubes drain fluid, blood, or air from the pleural space. This process can take several days. You may stay in the hospital while the tube is in place.
• Heimlich valves prevent fluid and air from getting into the chest when you breathe in. Your doctor may attach this one-way valve to a chest tube or indwelling pleural catheter (IPC), which allows you to move around more and may allow you to go home to wait for your lung to re-expand.
• IPC, or indwelling pleural catheters, are used to drain pleural fluid. An IPC is a semi-permanent thin tube that is left in place so patients or caregivers can drain the fluid, usually a few times a week.
• Injection of medicines into the pleural space may be needed to break up material that cannot be removed with a needle or drained through a chest tube.
• One-way endobronchial valve may be implanted in one of your  bronchial tubes  to allow air to exit the pleural space but not reenter.
• Pleurodesis is a procedure that can help close the pleural space by helping the two sides of the pleura stick together. For this procedure, your doctor will drain the fluid out of your chest through a chest tube. Then they will push a substance through the chest tube into the pleural space. The substance will irritate the surface of the pleura and cause the two layers of the pleura to stick together, preventing more fluid from building up.
• Surgery may be needed to remove fluid, pus, or blood clots that cannot be removed with a chest tube. You may also need surgery to remove part of the pleura, to remove one or more ribs; or to close the pleural space with a pleurodesis procedure.
• Thoracentesis is a procedure to remove air, blood, or other fluid from the pleural space with a needle. Possible complications include pneumothorax, pain, hemothorax and other bleeding, infection, and pulmonary edema. Complications are less likely if ultrasound is used to guide the procedure.

If left untreated, or if they do not respond well to treatment, pleural disorders can lead to serious health problems. Some of the possible complications include:

• Atelectasis, a partial or complete collapse of the lung, which can be a complication of pneumothorax
• Empyema, which is pus in the pleural space
• sepsis
• Shock, which is a life-threatening complication of hemothorax or tension pneumothorax that can happen when blood pressure drops dangerously low
• Unexpandable (trapped or entrapped) lung, which can be a complication of pleural effusion that is caused by cancer, hemothorax, or pleurisy