# Indwelling pleural catheter: draining fluid from the chest at home

Source: https://onco.cc/protocols/indwelling-pleural-catheter-drainage-at-home/  
OnCo record `indwelling-pleural-catheter-drainage-at-home` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An indwelling pleural catheter is a thin tube left in the chest so that fluid caused by cancer can be drained at home, by a nurse, a relative or yourself, using vacuum bottles. Drain as often as your breathing needs, or daily if the aim is for the fluid to stop; slow or stop if it hurts; and call the team for fever, redness, a damaged tube, or worse breathlessness when nothing drains.

## Summary

The BTS pleural guideline (2023) offers people with a malignant pleural effusion and no known non-expandable lung a choice of IPC or pleurodesis first line (conditional), and favours an IPC where more than a quarter of the lung will not re-expand. After insertion every patient should be referred to the community nursing team, and patients and relatives supported to drain and keep a drainage diary (good practice points). Drainage uses the manufacturer's vacuum bottles and procedure; the usual starting frequency is three times a week. Daily drainage raises the rate of spontaneous pleurodesis and shortens time to catheter removal (ASAP: 47% vs 24% with every-other-day drainage; AMPLE-2: 44.2% vs 15.9% at 6 months against symptom-guided drainage) without improving breathlessness, so BTS recommends daily drainage only where removal is a priority (conditional) and tells patients they do not need daily drainage to control breathlessness (strong, by consensus). About 500 mL is usually drained at a time, up to 1500 mL, slowed or stopped for pain or cough. Infection (pleural infection 3.2% to 5%) usually responds to antibiotics without removing the catheter (ATS/STS/STR, weak). Removal is considered after less than 50 mL on three consecutive drainages with no reaccumulation on imaging. Talc instilled through the IPC doubles pleurodesis at 35 days (43% vs 23%, IPC-PLUS) and BTS offers it where removal matters (conditional, by consensus).

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: IPC drainage; PleurX drainage at home; Rocket IPC drainage; tunnelled pleural catheter care; home drainage of a malignant pleural effusion; draining a pleural catheter

## Connected records

- protocols: [Care in the last days of life: recognising dying, hydration, symptom control and anticipatory medicines](https://onco.cc/protocols/care-in-the-last-days-of-life/), [Malignant ascites: paracentesis and indwelling peritoneal catheter drainage](https://onco.cc/protocols/malignant-ascites-drainage/)
- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Mesothelioma](https://onco.cc/cancers/mesothelioma/), [Pleural mesothelioma](https://onco.cc/cancers/pleural-mesothelioma/)
- technologies: [Indwelling pleural catheters for malignant pleural effusion (PleurX, Rocket, Aspira, Passio)](https://onco.cc/technologies/indwelling-pleural-catheters/)
- drugs: [Talc (intrapleural)](https://onco.cc/drugs/talc-sclerosant/)
- terms: [Malignant pleural effusion](https://onco.cc/terms/malignant-pleural-effusion/), [Malignant pleural effusion and ascites](https://onco.cc/terms/pleural-effusion/), [Pleurodesis and indwelling pleural catheter](https://onco.cc/terms/pleurodesis/)
- ideas: [Daily drainage of an indwelling pleural catheter offered to everyone whose lung re-expands and who wants the catheter out](https://onco.cc/ideas/idea-upgrade-daily-pleural-catheter-drainage-offered/)

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