Clinical predictors of successful and earlier pleurodesis with a tunnelled pleural catheter in malignant pleural effusion: a cohort study

Pen, Li; Graver, Alison; Hosseini, Sarah; Mulpuru, Sunita; Cake, Lorraine; Kachuik, Lynn; Zhang, Tinghua; Amjadi, Kayvan

doi:10.9778/cmajo.20170163

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…To our knowledge, this is the first published description of use of a shortened PleurX catheter for the ambulatory management of MPEs. We found that complication rates were low, and like previously published complication rates for the standard length PleurX catheter from our center 8. We also found that a large majority of nursing staff familiar with both catheters preferred the shorter catheter because of ease of use.…”

Section: Discussionsupporting

confidence: 84%

“…Indwelling pleural catheters (IPCs) are effective for the ambulatory management of MPEs and are suggested by current guidelines 3–6. Catheters are generally well tolerated, and complications are uncommon and include infection, catheter dislodgement, and the development of loculation 4–8…”

mentioning

confidence: 99%

“…[3][4][5][6] Catheters are generally well tolerated, and complications are uncommon and include infection, catheter dislodgement, and the development of loculation. [4][5][6][7][8]. Standard length, traditional, PleurX catheter, with cuff and external portion shown.…”

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confidence: 99%

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Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion

Rajchgot

Amjadi

2021

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: Indwelling pleural catheters are frequently used for the treatment of malignant pleural effusion. The PleurX catheter (Becton, Dickinson and Company) is a commonly used indwelling pleural catheter across Canada. The traditional PleurX catheter is designed with a long segment of tubing outside of the patient’s chest, making insertion, drainage, and dressing changes awkward. Our clinic developed a novel, shortened, PleurX catheter that is easier to handle. Methods: We conducted retrospective chart review for all patients treated with a shortened PleurX catheter at our center from December 2015 to May 2019 and demographics, clinical information, and complications were recorded retrospectively. A survey was designed and distributed to nurses experienced with the use of both catheters to elicit a preference between the short and long catheter. Results: We analyzed data from 503 catheters placed in 491 patients. The most frequently encountered complications were loculation requiring fibrinolytic (2.4%), catheter dislodgement (1.2%), and pleural infection (0.6%). Of nurses surveyed, 74% preferred using the shortened PleurX catheter. Conclusion: Complication rates of the novel, shortened PleurX catheter are low. Further research is needed to better determine the optimal catheter length for ambulatory management of malignant pleural effusion.

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Section: Discussionsupporting

confidence: 84%

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confidence: 99%

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Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion

Rajchgot

Amjadi

2021

Journal of Bronchology &Amp; Interventional Pulmonology

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“…It is proven to be a safe symptomatic procedure that improves the quality of life [66]. TPC is an alternative to pleurodesis for the treatment of recurrent MPE [74]. The advantages of the inserted TPC include clinically significant improvement in dyspnea, placement in the outpatient setting, and the ability of patient self-care at home.…”

Section: Management Of Mpementioning

confidence: 99%

Malignant Pleural Effusion and Its Current Management: A Review

et al. 2019

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Malignant pleural effusion (MPE) is an exudative effusion with malignant cells. MPE is a common symptom and accompanying manifestation of metastatic disease. It affects up to 15% of all patients with cancer and is the most common in lung, breast cancer, lymphoma, gynecological malignancies and malignant mesothelioma. In the last year, many studies were performed focusing on the pathophysiological mechanisms of MPE. With the advancement in molecular techniques, the importance of tumor-host cell interactions is becoming more apparent. Additionally, the process of pathogenesis is greatly affected by activating mutations of EGFR, KRAS, PIK3CA, BRAF, MET, EML4/ALK and RET, which correlate with an increased incidence of MPE. Considering all these changes, the authors aim to present a literature review of the newest findings, review of the guidelines and pathophysiological novelties in this field. Review of the just recently, after seven years published, practice guidelines, as well as analysis of more than 70 articles from the Pubmed, Medline databases that were almost exclusively published in indexed journals in the last few years, have relevance and contribute to the better understanding of the presented topic. MPE still presents a severe medical condition in patients with advanced malignancy. Recent findings in the field of pathophysiological mechanisms of MPE emphasize the role of molecular factors and mutations in the dynamics of the disease and its prognosis. Treatment guidelines offer a patient-centric approach with the use of new scoring systems, an out of hospital approach and ultrasound. The current guidelines address multiple areas of interest bring novelties in the form of validated prediction tools and can, based on evidence, improve patient outcomes. However, the role of biomarkers in a clinical setting, possible new treatment modalities and certain specific situations still present a challenge for new research.

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“…[ 19 ] Another study found that peritoneum, pelvic effusion and jejunal wall thickness of patients were significantly decreased after using diuretic combined with external application of mirabilite. [ 6 ] Another study also indicated that the external application of mirabilite could effectively reduce peritoneum and weight of the patients with ascites, increase urine volume, and relieve abdominal distention in 8 to 10 days. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

The clinical efficacy of external application of mirabilite and rhubarb combined with intrathoracic chemotherapy in treating malignant pleural effusion

Zhang

Jiang²,

Gao³

et al. 2021

Medicine

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Background: Malignant pleural effusion (MPE) is one of the commonest causes of an exudative pleural effusion. Breathlessness, dyspnea and other symptoms often seriously distress and affect the quality of life. The external application of mirabilite and rhubarb (EAMR) combined with intrathoracic infusion of cisplatin, as an alternative treatment for MPE, is popular in China. The study aims to assess its effectiveness and safety combined with intrathoracic chemotherapy. Methods: This study is a prospective, randomized controlled clinical trial. Patient visits were performed at baseline and days 14 and 28 after treatment. Clinical outcomes were measured after chest drain placement using the criterion of efficacy refer to WHO standard, and QLQ-C30 questionnaire. Results: Database records of patients treated in our institution for MPE between October, 2016 and March, 2019. The study included 84 eligible patients. They were categorized with a randomization schedule into treatment group (N = 42) and control group (N = 42). There is statistical significance in the comparison of the total effective rate between these 2 groups (66.67% vs 54.76%, P < .05). Furthermore, there is statistical significance in the comparison of items of Physical (1.95 ± 0.50 vs 2.19 ± 0.58%, P < .05), Pain (1.98 ± 0.42 vs 2.07 ± 0.32, P < .05), and Global Health (1.23 ± 0.64 vs 1.13 ± 0.23%, P < .05) between these 2 groups. None of the patients had adverse reactions such as skin allergy and chest tightness. Conclusions: The total effective rate of treatment group using extra external application of mirabilite rhubarb powder is significantly higher than that of control group. The improvement of patients’ clinical symptoms is greater in treatment group and no adverse reactions is found. Therefore, external application of mirabilite and rhubarb combined with intrathoracic infusion of cisplatin is an effective method for the treatment of MPE, which is worth popularizing.

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Clinical predictors of successful and earlier pleurodesis with a tunnelled pleural catheter in malignant pleural effusion: a cohort study

Abstract: Clinicians should consider numerous factors to predict the probability of and timing to pleurodesis with tunnelled pleural catheters.

Cited by 11 publications

References 17 publications

Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion

Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion

Malignant Pleural Effusion and Its Current Management: A Review

The clinical efficacy of external application of mirabilite and rhubarb combined with intrathoracic chemotherapy in treating malignant pleural effusion

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