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Prolonged air leak after IPC insertion: An unusual complication
Malvika Bhatnagar1, Robert Slight2,3, Arun Brahmanya Prasad1,4
1Department of Respiratory Medicine, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Road, High Heaton, Newcastle Upon Tyne, NE7 7DN, United Kingdom.
Respiratory Medicine Case Reports
|October 26, 2020
Summary
A rare complication of indwelling pleural catheters (IPC) for malignant pleural effusions is a significant air leak causing subcutaneous emphysema. Management requires intercostal drainage and negative suction, highlighting the need for physician awareness.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Devices
Background:
- Indwelling pleural catheters (IPC) are crucial for managing malignant pleural effusions.
- Effective management of malignant pleural effusions is essential for patient quality of life.
Observation:
- A patient developed extensive subcutaneous emphysema due to a significant air leak after IPC insertion.
- The air leak was presumed to result from visceral pleural disruption during fluid drainage, not lung injury.
Findings:
- Management involved inserting a large-bore intercostal drain with low-pressure negative suction.
- The patient was eventually discharged with an ambulatory system for ongoing management.
Implications:
- Emergency and respiratory physicians must be aware of this potential IPC complication.
- Understanding the management challenges of post-IPC air leaks is critical for clinical practice.
- This case underscores the importance of careful technique during IPC fluid drainage.
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