Management of Benign Pleural Effusions Using Indwelling Pleural Catheters

Patil, Monali; Dhillon, Samjot Singh; Attwood, Kristopher; Saoud, Marwan; Alraiyes, Abdul Hamid; Harris, Kassem

doi:10.1016/j.chest.2016.10.052

Cited by 68 publications

(56 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…IPC use is increasing with the increasing number of high quality clinical studies and randomized trials providing evidence of efficacious use [1,2], in both malignant and non-malignant disease [4,10]. While it is now established that in MPE, IPC and talc pleurodesis have similar beneficial effects on important patient outcomes such as breathlessness [1], the majority of studies have focused on short term, hospital focused outcomes such as hospital stay.…”

Section: Discussionmentioning

confidence: 99%

The Hospital and Patient Burden of Indwelling Pleural Catheters: A Retrospective Case Series of 210 Indwelling Pleural Catheter Insertions

et al. 2018

View full text Add to dashboard Cite

Background: Indwelling pleural catheters (IPC) offer an alternative to talc pleurodesis in recurrent effusion, especially in patients wishing to avoid hospitalization. Two randomized trials have demonstrated reduced time in hospital using IPCs versus talc pleurodesis in malignant pleural effusion (MPE). However, the impact of IPCs on hospital services and patients has not been well studied. Objectives: To analyze long-term outcomes of IPCs and understand the hospital burden in terms of requirement for hospital visits and contacts with healthcare, while the IPC was in situ. Methods: IPC insertions in a tertiary pleural center were analyzed retrospectively. Reviews of patients with IPCs in situ considered “additional” to routine clinical follow-up were defined pre-hoc. Results: A total of 202 cases were analyzed: 89.6% MPE group (n = 181) and 10.4% non-MPE group (n = 21). There were a median 3.0 (interquartile range [IQR] 3) and 2.0 (IQR 2) ipsilateral pleural procedures prior to each IPC insertion in non-MPE and MPE groups, respectively (p = 0.26), and a mean 1.3 (SD 1.7) planned IPC-related outpatient follow-up visits per patient. There were 2 (9.5%) and 14 (7.7%) IPC-related infections in non-MPE and MPE groups, respectively. Four (19.0%) and 44 (24.3%) patients required additional IPC-related reviews in non-MPE and MPE groups, respectively (p = 0.6), and these occurred within 250 days post IPC insertion. Conclusions: Although IPCs decrease initial length of hospital stay compared to talc pleurodesis via chest drain, IPCs are associated with significant hospital-visit burden, in addition to planned visits and regular home IPC drainages. IPC-using services need to be prepared for this additional work to run an IPC service effectively.

show abstract

Section: Discussionmentioning

confidence: 99%

The Hospital and Patient Burden of Indwelling Pleural Catheters: A Retrospective Case Series of 210 Indwelling Pleural Catheter Insertions

et al. 2018

View full text Add to dashboard Cite

show abstract

“…95 Indwelling pleural catheters have been shown to be effective in the management of refractory benign pleural effusions, but there is little evidence to make recommendations on their use specifically for rheumatoid pleural effusions. 109 Rheumatoid Nodulosis and Pneumoconiosis (Caplan's Syndrome)…”

Section: Managementmentioning

confidence: 99%

Pulmonary Complications of Rheumatoid Arthritis

Farquhar

Vassallo

Edwards

et al. 2019

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) is a common chronic autoimmune disorder that characteristically causes joint inflammation and damage. In addition, many patients develop extraarticular manifestations which may cause significant comorbidity and premature mortality.Some respiratory tract involvement of the upper and lower airways and parenchymal disease features are unique to RA, including cricoarytenoid arthritis and RA pulmonary nodulosis, and others, especially the interstitial parenchymal involvement, occur in many other idiopathic and autoimmune diseases. The pathophysiology of lung disease is not well understood. Rheumatoid lung disease may even predate the onset of joint disease, and could be triggered by chronic airway and alveolar epithelial injury. Chronic systemic inflammation and risk factors such as cigarette smoking, infection, host genetics, and immune dysregulation are contributors. Treatment of the respiratory disease is directed at reducing the systemic inflammation of RA. Less well understood is the management of the interstitial lung disease of RA, for which antifibrotic and immune suppressive agents may be helpful. The management of RA-related lung disease is perhaps the major remaining hurdle in reduction of the disease burden related to extraarticular manifestations of this disease.

show abstract

“…76 Several cases series have shown that pleurodesis is a plausible option. [77][78][79] The role of IPC in nonmalignant recurrent effusions is also expanding in this area, typically among those with heart failure or refractory hepatic hydrothorax (HH). Although the studies are relatively small, they do show that IPC is feasible, although time to pleurodesis is typically longer.…”

Section: Pleurodesis For Nonmalignant Effusionmentioning

confidence: 99%

Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Symptomatic pleural disease, specifically malignant pleural effusion, refractory benign pleural effusion, and pneumothoraces are common diseases that often require therapeutic interventions. The spectrum of management strategies often includes selection of a chemical pleurodesis agent administered in combination with an indwelling pleural catheter or chest tube.Additionally, there is a role for minimally invasive techniques which include medical thoracoscopy or more advanced video-assisted thoracoscopic approaches. Ongoing clinical trials continue to evolve best practices regarding the optimal sclerosant agents and procedural approaches in the management of these diseases.

show abstract

Management of Benign Pleural Effusions Using Indwelling Pleural Catheters

Cited by 68 publications

References 39 publications

The Hospital and Patient Burden of Indwelling Pleural Catheters: A Retrospective Case Series of 210 Indwelling Pleural Catheter Insertions

The Hospital and Patient Burden of Indwelling Pleural Catheters: A Retrospective Case Series of 210 Indwelling Pleural Catheter Insertions

Pulmonary Complications of Rheumatoid Arthritis

Pleurodesis

Contact Info

Product

Resources

About