Pleurodesis
| Pleurodesis | |
|---|---|
| Intervention | |
| ICD-9-CM | 34.92 |
| MeSH | D018700 |
Pleurodesis is a medical procedure in which the pleural space is artificially obliterated.[1] It involves the adhesion of the two pleurae.
Contents |
[edit] Uses
Pleurodesis is done to prevent recurrence of pneumothorax or recurrent pleural effusion. It can be done chemically or surgically.
[edit] Chemical
Chemicals such as bleomycin, tetracycline, povidone iodine, or a slurry of talc can be introduced into the pleural space through a chest drain. The instilled chemicals cause irritation between the parietal and the visceral layers of the pleura which closes off the space between them and prevents further fluid from accumulating.[2]
Povidone iodine is equally effective and safe as talc, and may be preferred because of easy availability and low cost.[3]
Chemical pleurodesis is a painful procedure, so patients are often premedicated with a sedative and analgesics. A local anesthetic may be instilled into the pleural space, or an epidural catheter may be placed for anesthesia.
[edit] Surgical
Surgical pleurodesis is performed via thoracotomy or thoracoscopy. This involves mechanically irritating the parietal pleura, often with a rough pad. Moreover, surgical removal of parietal pleura is an effective way of achieving stable pleurodesis.
[edit] References
- ^ "pleurodesis" at Dorland's Medical Dictionary
- ^ American Thoracic, Society (November 2000). "American Thoracic Society: Management of Malignant Pleural Effusions". Am J Respir Crit Care Med 162 (5): 1987–2001, 2000. PMID 11069845. http://www.thoracic.org/sections/publications/statements/pages/respiratory-disease-adults/1987.html.
- ^ Das SK, Saha SK, Das A, Halder AK, Banerjee SN, Chakraborty M (September 2008). "A study of comparison of efficacy and safety of talc and povidone iodine for pleurodesis of malignant pleural effusions". J Indian Med Assoc 106 (9): 589–90, 592. PMID 19552086.
