Respiratory failure following talc pleurodesis

Rehse, Dagmar H.; Aye, Ralph W.; Florence, Michael G.

doi:10.1016/s0002-9610(99)00075-6

Cited by 233 publications

(129 citation statements)

References 29 publications

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“…Postpleurodesis respiratory failure, which can be fatal, (15)(16)(17)(18)(19)(20) was not reported by the respondents in our study, and the reported incidence of empyema after pleurodesis ranged from 5% to 14%. However, we could not determine whether the occurrence of empyema was associated with a specific pleurodesis agent or whether it occurred in patients with poor performance status or inadequate lung expansion.…”

Section: Survivalmentioning

confidence: 51%

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

et al. 2010

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Objective: Pleurodesis is an effective alternative for the control of malignant pleural effusions. However, there is as yet no consensus regarding the indications for the procedure and the techniques employed therein. The objective of this study was to evaluate how pleurodesis is performed in South and Central America. Methods: Professionals who perform pleurodesis completed a questionnaire regarding the indications for the procedure, the techniques used therein, and the outcomes obtained. Results: Our sample comprised 147 respondents in Brazil, 49 in other South American countries, and 36 in Central America. More than 50% of the respondents reported performing pleurodesis only if pleural malignancy had been confirmed. However, scores on dyspnea and performance status scales were rarely used as indications for the procedure. Nearly 75% of the respondents in Brazil and in Central America preferred to perform pleurodesis only for recurrent effusions and stated that lung expansion should be 90-100%. Talc slurry, instilled via medium-sized chest tubes, was the agent most often employed. Thoracoscopy was performed in less than 25% of cases. Fever and chest pain were the most common side effects, and empyema occurred in ≤ 14% of cases. The mean survival time after the procedure was most often reported to be 6-12 months. Conclusions: There was considerable variation among the countries evaluated in terms of the indications for pleurodesis, techniques used, and outcomes. Talc slurry is the agent most commonly used, and thoracoscopy is the technique of choice in Brazil. Pleurodesis is an effective procedure that has few side effects, as evidenced by the low complication rates and high survival times.Keywords: Pleural effusion, malignant; Pleura; Pleurodesis. ResumoObjetivo: A pleurodese é uma alternativa eficaz no controle dos derrames pleurais malignos, mas existem controvérsias a respeito de sua indicação e técnica. O objetivo deste estudo foi avaliar como é realizada a pleurodese em países da América do Sul e Central. Métodos: Profissionais que realizam pleurodese responderam um questionário sobre critérios de indicação para pleurodese, técnicas utilizadas e desfechos. Resultados: Nossa amostra envolveu 147 profissionais no Brasil, 49 em outros países da América do Sul e 36 em países da América Central. Mais de 50% dos participantes realizavam pleurodese somente se confirmada a malignidade no derrame pleural. Entretanto, escalas de dispneia e de status de performance eram raramente utilizadas para indicar o procedimento. Aproximadamente 75% dos participantes no Brasil e na América Central preferiam realizar a pleurodese somente no caso de recidiva do derrame, e a expansão pulmonar deveria variar de 90% a 100%. O talco slurry foi o agente mais utilizado, instilado via drenos de calibre intermediário. A toracoscopia foi realizada em menos de 25% dos casos. Febre e dor torácica foram os efeitos adversos mais comuns, e empiema ocorreu em ≤ 14% dos casos. A média de sobrevida após o procedimento variou entre 6 e 12...

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Section: Survivalmentioning

confidence: 51%

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

et al. 2010

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“…West et al discussed three potential complications: fever, pain, and most importantly respiratory failure. The latter is thought to be dose dependent [9]. Other adverse effects include hypoxia, dyspnea, and pulmonary edema [9].…”

Section: Introductionmentioning

confidence: 99%

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Rafei¹,

Jabak²,

Mina³

et al. 2015

Integr Cancer Sci Therap

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Malignant pleural effusion is a common clinical problem in cancer patients. Many therapeutic techniques have been investigated, including pleurodesis. Little is known about the factors that may affect the success rate of such a procedure. The main objective of this study is to assess the success rates of pleurodesis performed on malignant pleural effusions in cancer patients at AUBMC and to identify the predictors of a successful pleurodesis. Patients diagnosed with malignant pleural effusions and who have undergone pleurodesis between years 2004 and 2013 at the American University of Beirut Medical Center were identified. Relevant information including patient, tumor and pleural effusion characteristics and outcome after pleurodesis was recorded. Data analysis was done to assess the success rate of pleurodesis as well as for the presence of statistically significant association between success of pleurodesis and the different clinical characteristics. Pleurodesis success rates were as follow: 17.7% had complete success, 12.9% had partial success, 40.3% had failed pleurodesis, 3.2% died shortly after pleurodesis, and 25.8% were lost to follow-up. When this failure rate was further analyzed in terms of the different clinical markers, only two parameters were found to be associated with different success rates of pleurodesis, namely the mean pH of the pleural fluid and the tube used to perform pleurodesis. The conclusions of this study will benefit future cancer patients presenting with malignant effusions. Based on this study's results a well as those of future studies, clinicians will cautiously plan the management of malignant pleural effusion and also refine the technique used.

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“…[37,38] Talk ile plöredez uygulamasında akut yan etkiler arasında, solunum yetmezliği ve ölüm gibi komplikasyonlar tarif edilmiştir. [39,40] Ancak 659 olgu ile yapılan kapsamlı bir diğer çalışmada talk nedeniyle gelişen akut solunum yetmezliği oranı %0.15 olarak raporlanmıştır. [41] Bizim plöredez yapılan 5 olgumuzda da bu çalışmaları destekler biçimde herhangi bir komplikasyon görülmemiş olup 5 olguda da hava kaçağı tamamen ortadan kalkmıştır.…”

Section: Discussionunclassified

Spontaneous Pneumothorax Treatment Modalities: A Study of 48 Cases

et al. 2011

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ÖZET AmaçSpontan pnömotoraks akciğer ile göğüs duvarı arasında serbest hava toplanmasıdır. Tanısı klinik ve/veya radyolojik olarak konur. Tedavi yaklaşımları açısından farklı uygulamalar mevcuttur. Bu ça-lışmada, pnömotoraks ve tedavi seçenekleri üzerindeki klinik tecrü-belerimizi literatür bilgileri eşliğinde tartıştık. Gereç ve YöntemKliniğimize başvuran 48 spontan pnömotoraks olgusu prospektif olarak değerlendirildi. Çalışmamıza primer spontan pnömotoraks olguları dahil edildi. Olgular yaş, cinsiyet, ek hastalıklar, semptomlar, cerrahi yöntemler ve takip açısından değerlendirildi. BulgularYirmi olgu (%41.7) total pnömotoraks, 28 olgu (%58.3) parsiyel pnö-motoraks idi. Otuz bir (%64.6) olgu ilk pnömotoraks iken 17 (%35.4) olgu nüks pnömotoraks idi; 26 (%54.2) sol, 22 (%45.8) sağ pnömo-toraks mevcuttu. Spontan pnömotoraks tedavi yöntemleri arasında farklı uygulamalar mevcuttur. Olguların 38'i yalnızca tüp torakostomi, 5'i plöredez ve 6'sı bül ligasyonu ile tedavi edildi. SonuçSpontan pnömotoraks tedavisindeki amaç nüksü önlemek olmalı-dır. Tüp torakostomiye ilave olarak plöredez ve gerekli durumlarda cerrahi tedavi gündeme gelir. Hastanede kalış süresini kısalt-mak, hastanın konforunu arttırıcı yaklaşımları tercih etmek önemli-dir. Nüks pnömotoraks tedavisinde tüp torakostomiye ek olarak bir plöredez veya plörektomi prosedürü mutlaka uygulanmalıdır.Anahtar sözcükler: Bül ligasyonu; plöredez; spontan pnömotoraks. SUMMARY Objectives Spontaneous pneumothorax is defined as the collection of free air between the lung and chest wall, and is diagnosed clinically and radiologically. Treatment approaches to this condition are variable. In our study, we discussed our experience on pneumothorax and its treatment options in light of relevant literature. Methods patients with spontaneous

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Respiratory failure following talc pleurodesis

Cited by 233 publications

References 29 publications

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Spontaneous Pneumothorax Treatment Modalities: A Study of 48 Cases

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