Rapid pleurodesis for malignant pleural effusions

A pilot study

Chakravarthy Reddy, Armin Ernst, Carla Lamb, David Feller-Kopman

Research output: Contribution to journalArticle

Abstract

Background: Malignant pleural effusions (MPEs) affect > 150,000 people each year in the United States. Current palliative options include pleurodesis and placement of an indwelling catheter, each with its own associated benefits. This study was conducted to determine the safety, efficacy, and feasibility of a rapid pleurodesis protocol by combining medical thoracoscopy with talc pleurodesis and simultaneous placement of a tunneled pleural catheter (TPC) in patients with symptomatic MPE. Methods: Patients with recurrent, symptomatic MPEs underwent medical thoracoscopy with placement of a TPC and talc poudrage. The TPC was drained per protocol until the output was <150 mL/d on two consecutive drainage attempts and then removed. Patients were followed for up to 6 months. Results: Between October 2005 and September 2009, 30 patients underwent the procedure. The median duration of hospitalization following the procedure was 1.79 days. All patients showed an improvement in dyspnea and quality of life. Pleurodesis was successful in 92% of patients, and the TPC was removed at a median of 7.54 days. Complications included fever (two patients), the need for TPC replacement (one patient), and empyema (one patient). Conclusion: Rapid pleurodesis can be achieved safely by combining medical thoracoscopy and talc poudrage with simultaneous TPC placement. Both hospital length of stay and duration of TPC use can be reduced significantly as compared with historical controls of either procedure alone. Future randomized trials are needed to confirm these results.

Original languageEnglish (US)
Pages (from-to)1419-1423
Number of pages5
JournalChest
Volume139
Issue number6
DOIs
StatePublished - Jun 1 2011

Fingerprint

Pleurodesis
Malignant Pleural Effusion
Catheters
Talc
Thoracoscopy
Length of Stay
Empyema
Indwelling Catheters
Dyspnea
Drainage
Hospitalization
Fever
Quality of Life
Safety

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Rapid pleurodesis for malignant pleural effusions : A pilot study. / Reddy, Chakravarthy; Ernst, Armin; Lamb, Carla; Feller-Kopman, David.

In: Chest, Vol. 139, No. 6, 01.06.2011, p. 1419-1423.

Research output: Contribution to journalArticle

Reddy, Chakravarthy ; Ernst, Armin ; Lamb, Carla ; Feller-Kopman, David. / Rapid pleurodesis for malignant pleural effusions : A pilot study. In: Chest. 2011 ; Vol. 139, No. 6. pp. 1419-1423.
@article{49fdb96bed514851881b80b37bda23f7,
title = "Rapid pleurodesis for malignant pleural effusions: A pilot study",
abstract = "Background: Malignant pleural effusions (MPEs) affect > 150,000 people each year in the United States. Current palliative options include pleurodesis and placement of an indwelling catheter, each with its own associated benefits. This study was conducted to determine the safety, efficacy, and feasibility of a rapid pleurodesis protocol by combining medical thoracoscopy with talc pleurodesis and simultaneous placement of a tunneled pleural catheter (TPC) in patients with symptomatic MPE. Methods: Patients with recurrent, symptomatic MPEs underwent medical thoracoscopy with placement of a TPC and talc poudrage. The TPC was drained per protocol until the output was <150 mL/d on two consecutive drainage attempts and then removed. Patients were followed for up to 6 months. Results: Between October 2005 and September 2009, 30 patients underwent the procedure. The median duration of hospitalization following the procedure was 1.79 days. All patients showed an improvement in dyspnea and quality of life. Pleurodesis was successful in 92{\%} of patients, and the TPC was removed at a median of 7.54 days. Complications included fever (two patients), the need for TPC replacement (one patient), and empyema (one patient). Conclusion: Rapid pleurodesis can be achieved safely by combining medical thoracoscopy and talc poudrage with simultaneous TPC placement. Both hospital length of stay and duration of TPC use can be reduced significantly as compared with historical controls of either procedure alone. Future randomized trials are needed to confirm these results.",
author = "Chakravarthy Reddy and Armin Ernst and Carla Lamb and David Feller-Kopman",
year = "2011",
month = "6",
day = "1",
doi = "10.1378/chest.10-1868",
language = "English (US)",
volume = "139",
pages = "1419--1423",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "6",

}

TY - JOUR

T1 - Rapid pleurodesis for malignant pleural effusions

T2 - A pilot study

AU - Reddy, Chakravarthy

AU - Ernst, Armin

AU - Lamb, Carla

AU - Feller-Kopman, David

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Background: Malignant pleural effusions (MPEs) affect > 150,000 people each year in the United States. Current palliative options include pleurodesis and placement of an indwelling catheter, each with its own associated benefits. This study was conducted to determine the safety, efficacy, and feasibility of a rapid pleurodesis protocol by combining medical thoracoscopy with talc pleurodesis and simultaneous placement of a tunneled pleural catheter (TPC) in patients with symptomatic MPE. Methods: Patients with recurrent, symptomatic MPEs underwent medical thoracoscopy with placement of a TPC and talc poudrage. The TPC was drained per protocol until the output was <150 mL/d on two consecutive drainage attempts and then removed. Patients were followed for up to 6 months. Results: Between October 2005 and September 2009, 30 patients underwent the procedure. The median duration of hospitalization following the procedure was 1.79 days. All patients showed an improvement in dyspnea and quality of life. Pleurodesis was successful in 92% of patients, and the TPC was removed at a median of 7.54 days. Complications included fever (two patients), the need for TPC replacement (one patient), and empyema (one patient). Conclusion: Rapid pleurodesis can be achieved safely by combining medical thoracoscopy and talc poudrage with simultaneous TPC placement. Both hospital length of stay and duration of TPC use can be reduced significantly as compared with historical controls of either procedure alone. Future randomized trials are needed to confirm these results.

AB - Background: Malignant pleural effusions (MPEs) affect > 150,000 people each year in the United States. Current palliative options include pleurodesis and placement of an indwelling catheter, each with its own associated benefits. This study was conducted to determine the safety, efficacy, and feasibility of a rapid pleurodesis protocol by combining medical thoracoscopy with talc pleurodesis and simultaneous placement of a tunneled pleural catheter (TPC) in patients with symptomatic MPE. Methods: Patients with recurrent, symptomatic MPEs underwent medical thoracoscopy with placement of a TPC and talc poudrage. The TPC was drained per protocol until the output was <150 mL/d on two consecutive drainage attempts and then removed. Patients were followed for up to 6 months. Results: Between October 2005 and September 2009, 30 patients underwent the procedure. The median duration of hospitalization following the procedure was 1.79 days. All patients showed an improvement in dyspnea and quality of life. Pleurodesis was successful in 92% of patients, and the TPC was removed at a median of 7.54 days. Complications included fever (two patients), the need for TPC replacement (one patient), and empyema (one patient). Conclusion: Rapid pleurodesis can be achieved safely by combining medical thoracoscopy and talc poudrage with simultaneous TPC placement. Both hospital length of stay and duration of TPC use can be reduced significantly as compared with historical controls of either procedure alone. Future randomized trials are needed to confirm these results.

UR - http://www.scopus.com/inward/record.url?scp=79953268917&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953268917&partnerID=8YFLogxK

U2 - 10.1378/chest.10-1868

DO - 10.1378/chest.10-1868

M3 - Article

VL - 139

SP - 1419

EP - 1423

JO - Chest

JF - Chest

SN - 0012-3692

IS - 6

ER -