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

Abstract

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.

Incidence of complications from indwelling pleural catheter for pleural effusion: A meta‐analysis

“…As shown in Figure 1, 7486 relevant studies were initially identified, among which 82 were retained for further evaluation. We ultimately included 41 studies published between 1999 and 2021 15–55 . Table 1 shows basic study information and the results of the quality evaluations of the included studies.…”

“…We ultimately included 41 studies published between 1999 and 2021. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 Table 1 shows basic study information and the results of the quality evaluations of the included studies.…”

Are Indwelling Pleural Catheters Too Long?

“…However, they noted that a majority of nurses preferred the shorter catheter. 3 Three respondents (11%) preferred the longer catheter, 20 respondents (74%) preferred the shorter catheter, and 4 respondents (15%) had no preference. The most cited reasons for a preference for the shorter catheter included easier catheter manipulation (7 respondents), easier dressing changes (11 respondents), perceived improvements in patient comfort (5 respondents), and easier maintenance of sterility (4 respondents).…”

“…The most cited reasons for a preference for the shorter catheter included easier catheter manipulation (7 respondents), easier dressing changes (11 respondents), perceived improvements in patient comfort (5 respondents), and easier maintenance of sterility (4 respondents). Respondents who preferred the longer catheter cited easier catheter manipulation with the longer catheter (2 respondents) 3…”

“…Respondents who preferred the longer catheter cited easier catheter manipulation with the longer catheter (2 respondents). 3 The study by Rajchgot and colleagues had several limitations. First, there is no data to support the authors' claim that handling the longer catheter…”