After your IPC procedure
Do not drive for 48 hours.
Do not use public transport to go home.
Arrange for someone to:
- drive you home or stay with you if you take a taxi home
- stay with you overnight in case you feel unwell.
Recovery at home
Most people go home on the same day as the IPC insertion.
Pain/itching
You may experience pain and redness around your IPC during the first few days. This is normal. Your chest may feel bruised or sore. This can last up to 1 week.
We advise you to take your usual over-the-counter painkillers, such as paracetamol. You may be able to take ibuprofen as well, but we advise against ibuprofen if:
- you have a kidney condition
- you experience stomach ulcers
- you are on blood thinners.
Check with your doctor if you are unsure and always follow the instructions on the painkiller packaging.
People often experience itching for the first few days. You can try taking over-the-counter antihistamine tablets to reduce the itching.
Washing/wound dressings
| You must keep the wound dry for 2 weeks after the procedure. Do not swim and do not take a bath. |
We will use a dressing to cover the area where we insert the IPC. As long as you keep the insertion site clean and dry, you can take a shower. Most patients find it easiest to use a handheld shower.
Change your dressing if it feels loose after a shower.
You may choose to shower just before you drain the wound, when you (or your district/GP practice nurse) will be changing your dressing anyway. You will need to keep using dressings for as long as you use an IPC.
After 2 weeks you can shower and bath. After your shower or bath, make sure the wound site is clean and dry, and put on a fresh dressing.
Your district nurse can supply you with extra dressings.
Everyday activities
- For 2 weeks afterwards, stick to gentle activities such as walking, light housework or light gardening.
- Avoid any activity (including contact sports) that can disturb the IPC or cause the dressing to be pulled off by accident.
- After 2 weeks most patients return to their usual routine of activities.
- After 1 month, you will be able to go swimming if your entry site is healing well. Make sure you keep the dressing and the entry site clean. If necessary, replace the dressing after you swim.
- Avoid leaving a wet dressing in contact with your skin or the IPC.
| You can drive or fly with your IPC in place. |
Draining the fluid at home
- Most people find draining to be an easy procedure.
- Your district nurse will show you how to drain the fluid for the first time. Use the supply of IPC bottles we give you to take home.
- If you prefer, someone you know can regularly drain the fluid for you.
- People usually drain their fluid 2 or 3 times a week.
Bottle supply
We will give you 2 or 3 bottles to take home. This is enough for 1 week of fluid drainage.
We will send your GP a letter, asking them to prescribe extra bottles and wound dressings, which you can collect from your local pharmacy.
Check with your GP/pharmacy to make sure that your bottles will be ready. (It can take a few days for bottles to arrive).
We will give you a drainage booklet which includes information on looking after your IPC and ordering extra bottles. You can also use this booklet to record how much fluid you drain from the IPC.
|
You cannot dispose of used fluid bottles with your household waste. Your district nurse will let you know the best way to dispose of them in your local area. |
If fluid stops draining
If the fluid stops draining, it may mean your IPC is blocked. Get in touch with your Lung CNS (clinical nurse specialist) if this happens.
If you find you are gradually draining less fluid over days or weeks, it may mean you are producing less. Get in touch with your Lung CNS to let them know.
Changes in fluid colour
Changes in fluid colour can be normal (including reddish fluid due to blood staining). Cloudy fluid can indicate infection, and we will need to test a fluid sample.
Make a note of any change of colour in your drainage diary, so we can review it at your next appointment.
Contact your Lung CNS if you have any questions or concerns.
Risks
IPC insertion is a routine procedure. It is safe for most patients, but there are some risks.
Sometimes we are unable to insert the IPC. This can be for technical reasons, such as an inadequate amount of pleural fluid in the chest cavity to allow safe insertion of the IPC. If this happens we will discuss next steps with you.
During or shortly after surgery
| Common (more than 5 in 100) | Pain. We suggest over-the-counter paracetamol for at least the first 24 hours. You may need to take it for a further 48 hours, if needed. Always follow the instructions on the packaging. (Also see 'Pain/itching' above). |
| Less common (fewer than 5 in 100) |
Air build-up between lung and chest wall (pneumothorax). This may require a temporary chest drain insertion. Surrounding structure damage (can lead to pneumothorax). |
| Rare (fewer than 1 in 100) | Significant bleeding which may need a blood transfusion or further emergency treatment. |
In the days or weeks after surgery
| Less common (fewer than 5 in 100) |
Build-up of pus in a body cavity. This may need treatment with antibiotics (as an inpatient) and we may need to remove the IPC. Wound infection. May require treatment with antibiotics or occasionally fluid drainage or further surgery. To avoid this, we will teach you how to keep your tube clean. Pleural catheter complications which may need replacement IPC procedure. Tumour spread (along catheter) which, if needed, can be treated with targeted radiology. Catheter tube fracture. If you no longer need the IPC and we can remove it, there is a risk that some of it may be left behind. This might not require further treatment, but you could need a CT scan to assess this further. |
Risks of having a long-term IPC
The main risk is infection in your chest. Always follow the instructions on how to look after your IPC. This will reduce the risk of infection.
- Check the area regularly for signs of infection. Signs include redness, swelling, oozing pus or liquid, pain or a high temperature (fever).
- Tell your district nurse, GP or lung CNS as soon as possible if you experience these symptoms. You may need treatment with antibiotics.
- Tell your doctor if you get a lump or any pain around your catheter in the weeks after we insert it.
When to seek medical help
Get in touch with your district nurse, lung CNS or GP if you experience any of the following:
- a higher temperature (fever)
- pain around the IPC site that is getting worse
- redness or swelling around the IPC site
- dizziness
- vomiting.
Follow-up
- The Kingston Hospital Pleural Clinic will offer you a telephone clinic appointment 4 to 6 weeks after we insert the IPC.
- You will need to arrange a chest X-ray just before this appointment. You can use the Kingston Hospital Walk-In X-ray service to have your X-ray (Monday to Friday, 08.30 to 5 pm). You do not need to book ahead for this.
- Your telephone appointment cannot go ahead unless you have had your X-ray.
More information
Kingston Hospital information on IPC: preparation and procedure [LVS to add link when leaflet published]
NHS information for anyone with breathing difficulties caused by a cancer-related collection of chest fluid: My pleural effusion journey
Contact information
Kingston Hospital Respiratory Medicine, Monday to Friday 9am to 5pm
Kingston Hospital Lung CNS Department. Email: krft.