Malignant pleural effusions and trapped lung

Petrov, Danail; Mihalova, Teodora; Valchev, Daniel

doi:10.21037/amj.2020.02.08

Cited by 2 publications

(10 citation statements)

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“…Complete thoracentesis fluid drainage and lung re-expansion can exclude trapped lung, when thickening of the visceral pleural prevents lung re-expansion; a setting in which pleurodesis would be contraindicated. 28,33,34 It also confirms that symptoms are relieved when fluid is removed and are not caused by another etiology such as pulmonary embolism or pericardial effusion. The ATS/STS/STR 2018 guidelines recommend TPC in cases of trapped lung, and instead of repeat pleurodesis when the first attempt has failed.…”

Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 65%

“…The ATS/STS/STR 2018 guidelines recommend TPC in cases of trapped lung, and instead of repeat pleurodesis when the first attempt has failed. 17,34 Finally, it is worth comparing percutaneous catheter based chemical pleurodesis to VATS-guided pleurodesis. Multiple randomized control trials have compared talc slurry infusion via percutaneous catheter to talc poudrage insufflation during VATS for malignant effusions and have found no significant difference in pleurodesis success rate, hospital stay or respiratory complications.…”

Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 99%

“…66 Prior to treatment, initial thoracentesis should be performed to exclude the presence of loculations or trapped lung. 34 While thoracentesis can be performed without image-guidance, ultrasound-guidance enhances procedural success and reduces the need for future procedures. 67 Techniques for thoracentesis are described in the previous article in this issue.…”

Section: Overview Of Types Of Sclerosantsmentioning

confidence: 99%

“…The ATS/STS/STR 2018 guidelines recommend TPC in cases of trapped lung, and instead of repeat pleurodesis when the first attempt has failed. 17 34…”

Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 99%

“…It is usually due to trapped lung or loculated pleural effusion, which may necessitate alternate interventions such as fibrinolytics, TPC placement or VATS decortication. 28 34 Many studies recommend attempting repeat pleurodesis or switching to TPC placement to attempt autopleurodesis. 90…”

Section: Complications and Managementmentioning

confidence: 99%

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Treating Recurrent Pleural Disease: A Review of Indications and Technique for Chemical Pleurodesis for the Interventional Radiologist

Trivedi

Niemeyer

2022

Semin intervent Radiol

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Pleural space diseases such as recurrent pleural effusion and pneumothorax inflict a significant symptomatic burden on patients. Guidelines and studies are available to guide best practices in the setting of refractory effusions, mostly in the setting of malignancy, and recurrent pneumothorax. Less data is available to guide management of refractory transudative effusions. Recurrent pleural effusions can be treated with tunneled pleural catheters or catheter-based pleurodesis. While refractory transudative effusions can benefit from tunneled pleural catheter, this is an area of ongoing research. Regarding recurrent pneumothorax, video-assisted thoracoscopic surgery (VATS) pleurodesis using mechanical or laser/argon beam coagulation is the most effective means of preventing recurrence. Catheter based pleurodesis, a less invasive means of administering chemical sclerosant via percutaneous thoracostomy tube, is only used when surgery is not an option. However, both approaches induce inflammation of the pleural space, resulting in adherence of the parietal and visceral pleura to prevent fluid or air re-accumulation. This article will discuss catheter based chemical pleurodesis geared toward the interventional radiologist, including a review of disease processes and indications, technique, and strategies to mitigate complications as well as a literature review comparing percutaneous chemical pleurodesis to other therapies.

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Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 65%

Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 99%

Section: Overview Of Types Of Sclerosantsmentioning

confidence: 99%

“…The ATS/STS/STR 2018 guidelines recommend TPC in cases of trapped lung, and instead of repeat pleurodesis when the first attempt has failed. 17 34…”

Section: Pleural Effusions: Pathophysiology and Managementmentioning

confidence: 99%

Section: Complications and Managementmentioning

confidence: 99%

See 3 more Smart Citations

Treating Recurrent Pleural Disease: A Review of Indications and Technique for Chemical Pleurodesis for the Interventional Radiologist

Trivedi

Niemeyer

2022

Semin intervent Radiol

View full text Add to dashboard Cite

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Clinical predictors and outcomes of non-expandable lung following percutaneous catheter drainage in lung cancer patients with malignant pleural effusion

et al. 2023

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Non-expandable lung (NEL) often occurs during pleural fluid drainage in patients with malignant pleural effusion (MPE). However, data regarding the predictors and prognostic impact of NEL on primary lung cancer patients with MPE receiving pleural fluid drainage, compared to malignant pleural mesothelioma (MPM), are limited. This study was aimed to investigate the clinical characteristics of lung cancer patients with MPE developing NEL following ultrasonography (USG)-guided percutaneous catheter drainage (PCD) and compare the clinical outcomes between those with and without NEL. Clinical, laboratory, pleural fluid, and radiologic data and survival outcomes of lung cancer patients with MPE undergoing USG-guided PCD were retrospectively reviewed and compared between those with and without NEL. Among 121 primary lung cancer patients with MPE undergoing PCD, NEL occurred in 25 (21%). Higher pleural fluid lactate dehydrogenase (LDH) levels and presence of endobronchial lesions were associated with development of NEL. The median time to catheter removal was significantly extended in those with NEL compared to those without (P = .014). NEL was significantly associated with poor survival outcome in lung cancer patients with MPE undergoing PCD, along with poor Eastern Cooperative Oncology Group (ECOG) performance status (PS), the presence of distant metastasis, higher serum C-reactive protein (CRP) levels, and not receiving chemotherapy. NEL developed in one-fifth of lung cancer patients undergoing PCD for MPE and was associated with high pleural fluid LDH levels and the presence of endobronchial lesions. NEL may negatively affect overall survival in lung cancer patients with MPE receiving PCD.

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Malignant pleural effusions and trapped lung

Cited by 2 publications

References 0 publications

Treating Recurrent Pleural Disease: A Review of Indications and Technique for Chemical Pleurodesis for the Interventional Radiologist

Treating Recurrent Pleural Disease: A Review of Indications and Technique for Chemical Pleurodesis for the Interventional Radiologist

Clinical predictors and outcomes of non-expandable lung following percutaneous catheter drainage in lung cancer patients with malignant pleural effusion

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