Indwelling Pleural Catheter Placement for Nonmalignant Pleural Effusions

Abstract

Pleural effusions account for significant symptoms and morbidity. Recent studies demonstrate a high mortality in patients with “benign” pleural effusions, now better characterized as nonmalignant pleural effusions (NMPEs) based on their prognosis. The most common nonmalignant clinical conditions with recurrent pleural effusions are congestive heart failure and hepatic hydrothorax, although many other diseases exist in isolation or as comorbid conditions. When conventional therapy fails, thoracentesis is often performed for relief of dyspnea. Many times, however, the effusions recur despite maximal medical therapy. Placement of tunneled or indwelling pleural catheters provides an effective therapeutic strategy for recurrent NMPEs when other medical therapy fails.

The Global Burden of Pleural Diseases

“…In a 2018 article in Seminars, Bramley and colleagues reviewed the role of indwelling pleural catheters in this cohort. 91 Indwelling catheters appear safe and effective, but most studies had only a small number of patients. 91 This might reflect the low incidence of refractory effusion in heart failure but may also reflect the frequency with which indwelling catheters are offered to these patients.…”

Indwelling pleural catheters for benign pleural effusions: a concise review

“…Frequent thoracentesis may be required in patients refractory to medical management and can be a reasonable option in those requiring infrequent drainage. However, patients who require more than one or two thoracenteses in a month may benefit from an alternative approach [12].…”

Komplikationen nach pleuralem getunnelten Dauerkatheter bei symptomatischen rezidivierenden benignen und malignen Pleuraergüssen

“…Auch bei Patienten mit rezidivierenden BPE unter maximaler konservativer Therapie führt der getunnelte Dauerkatheter zur stabilen Symptomkontrolle, Verringerung der Krankenhauseinweisungen und spontanen Pleurodese in ca. 50 % der Fälle [2,3].…”