Pleurodesis & Fibrinolysis Therapy in Delhi

Pleurodesis/Fibrinolysis

Pleurodesis is a procedure in which the pleural layers (lining of the lungs and chest wall) are made to stick together so that fluid or air can no longer collect in the pleural space. This is done by introducing a chemical or medication into the pleural space to cause controlled inflammation and fusion of the layers.

Fibrinolysis is the use of special medications (fibrinolytic agents) to break down thick pus or fibrous bands (septations) in the pleural space, allowing proper drainage in infections like empyema.

Why is it Done?

Pleurodesis is often needed for:

Recurrent pleural effusion the fluid build-up that keeps coming back which is common in cancer, chronic heart/liver/kidney disease.
Recurrent pneumothorax is the air leak that returns again and again.
Certain cases of malignant pleural effusion where repeated drainage is not practical.

Fibrinolysis is often needed for:

Complicated pleural infections (empyema) with thick, loculated pus.
Clotted haemothorax (blood in pleural space that has clotted).
To avoid surgery when infection is caught early.

Symptoms

Breathlessness
Chest pain
Cough due to lung compression
Repeated hospital visits for drainage
Persistent infection that does not improve with antibiotics alone

How to Prepare for the test?

It is usually performed in hospital.
Chest X-ray / CT scan and ultrasound to assess fluid.
Blood tests to check clotting profile.
Inform doctor about any allergies or blood thinners.
Fasting may be required if sedation is planned.

How is it Done?

Pleurodesis:

A chest tube is inserted to completely drain the fluid or air.
Once lung is fully expanded, a pleurodesis agent (e.g., sterile talc, doxycycline, and bleomycin) is introduced into the pleural space through the tube.
The patient may be repositioned in bed so the medicine spreads evenly.
Tube is clamped for a short time, then reopened to drain.

Fibrinolysis:

A chest tube is inserted into the infected pleural space.
Fibrinolytic drug (e.g., urokinase, streptokinase, tPA) is given through the tube.
This breaks down fibrous septations, allowing pus or fluid to drain freely.

Frequently Asked Questions (FAQs)

1. Is pleurodesis permanent?

Yes, it is meant to be a permanent solution to prevent recurrence of pleural fluid or air.

2. Will pleurodesis affect breathing?

No, most people breathe normally after recovery; it prevents lung compression from future fluid/air.

3. How successful is fibrinolysis?

In early-stage empyema, it can avoid surgery in over 70–80% of cases.

4. Is pleurodesis painful?

Some chest discomfort is expected, but it is controlled with painkillers.

Pleurodesis/Fibrinolysis