Pleural fluid CRP, LDH, and pH as predictors of successful pleurodesis in malignant pleural effusions

Shehata, S. A.; Sileem, Ashraf E.; El-Fakharany, Kareem M.

doi:10.1016/j.ejcdt.2015.05.003

Cited by 11 publications

(15 citation statements)

References 20 publications

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“…43,44 Pleural fluid pH or glucose was not found to have any effect on the ability to achieve pleurodesis when using C. parvum, which has been a concern with other sclerosants. 45,46 Compared with doxycycline, pleurodesis rates were similar but more side effects were noted with C. parvum. 47…”

Section: Bacterial Agentsmentioning

confidence: 99%

“…32 Furthermore, the use of silver nitrate instillation as a "rescue" after failed talc poudrage showed 89% efficacy; although 1,000 mg was used, minimal side effects were noted. 33 Table 1 Agents used for pleurodesis [14][15][16][17][18][19]27,28,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] When evaluating the safety profile, there was equal success when using doses of 90, 150, and 180 mg with dose-dependent increases in systemic inflammatory responses, suggesting the lower dose is preferable. 34 However, pain control was a significant concern, 35 resulting in the decline in its use.…”

Section: Silver Nitratementioning

confidence: 99%

“…Predictive accuracy remains modest. 46,71,72 The PROMISE score (►Table 3) helped predict survival that appeared to perform better than the LENTscore. 73 Pleurodesis success rates are also affected by tumor types, where those with mesothelioma and lung cancer-associated MPE failing more often when compared with MPE secondary to breast cancer (53 and 58% vs. 75%).…”

Section: Malignant Pleural Effusionsmentioning

confidence: 99%

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Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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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.

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Section: Bacterial Agentsmentioning

confidence: 99%

Section: Silver Nitratementioning

confidence: 99%

Section: Malignant Pleural Effusionsmentioning

confidence: 99%

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Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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“…Kegagalan pleurodesis terjadi apabila nilai LDH cairan pleura tinggi, nilai glukosa cairan pleura rendah, dan nilai pH cairan pleura rendah. 15,18 Pada penelitian ini keberhasilan pleurodesis didapatkan lebih tinggi pada penderita yang mempunyai nilai glukosa cairan pleura yang tinggi dibandingkan dengan penderita dengan nilai glukosa cairan pleura yang rendah. Hal ini diketahui dengan nilai rerata glukosa cairan pleura pada kegagalan pleurodesis sebesar 65,50, sedangkan nilai rerata glukosa cairan pleura pada keberhasilan pleurodesis sebesar 113,40.…”

Section: Pembahasan Hubungan Nilai Ph Cairan Pleura Yang Rendah Dengaunclassified

“…Disimpulkan bahwa keberhasilan pleurodesis lebih besar jika pH cairan pleura > 7,30 dan nilai glukosa cairan pleura > 60 mg/dl. 18,34 Penelitian Ioannis Pantazopoulos terhadap 161 penderita didapatkan angka keberhasilan pleurodesis pada penderita dengan nilai glukosa 101 mg/dl (67-138), sedangkan ketidakberhasilan pleurodesis pada nilai glukosa cairan pleura 40,5 mg/dl (22-61). Hubungan antara nilai glukosa cairan pleura dengan hasil pleurodesis secara statistik signifikan dengan nilai p < 0,001.…”

Section: Pembahasan Hubungan Nilai Ph Cairan Pleura Yang Rendah Dengaunclassified

Hubungan Nilai PH Cairan Pleura dengan Hasil Pleurodesis pada Penderita Efusi Pleura karena Keganasan

Marhana

Handoko

2019

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Background: Pleural effusion is a frequent complication of advanced stage are obtained in patients with malignancy. Shortness of breath at rest and decreased exercise tolerance are major functional limitations for patients with cancer who develop extensive pleural effusion. Pleural fluid drainage followed by a pleurodesis can reduce the symptoms of shortness of breath and prevent pleural fluid reaccumulation. Unfortunately, pleurodesis attempts fail in 10 to 40% of patients with recurrent pleural fluid and shortness of breath. Low pleural fluid pH can be used as a marker for increased metabolic activity of tumors in intrapleura, and is associated with increasing tumor, and can predict the failure of pleurodesis. The purpose of this study was to prove association between low pleural fluid pH value with failure pleurodesis in patients pleural effusion malignancy. Method: This is an observational study with cross sectional design that is the analysis conducted at Hospital Dr Soetomo in patients pleural effusion malignancy were subjected to pleurodesis for 6 months. Total 11 patients who meet the inclusion and exclusion criteria. Result: The mean value obtained pleural fluid pH 7,3±0,2, based on logistic regression analysis obtained low pleural fluid pH is not significant association with failure of pleurodesis, as shown from the significant value generated wald test is 0,116 where the value is above 0,05. Conclusion: Low pleural fluid pH is not significant association with failure of pleurodesis.

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