Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Burgers, Jacobus A.; Kunst, Peter W.A.; Koolen, Marijn; Willems, L. N. A.; Burgers, Jako; Heuvel, Marcel van den

doi:10.1183/09031936.00165607

Cited by 35 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The American Thoracic Society/European Respiratory Society guideline for the management of MPE recommends that pleurodesis should be limited to patients with pleural fluid pH values greater than 7.30, because of the direct correlation between low pH and poor shortterm survival [15][16][17]. This was not found to be the case in a European study that showed no association between success and LDH and pH [18]. In another Egyptian study that compared the success of different techniques of pleurodesis for malignant pleural effusion, the group subjected to pigtail drainage then pleurodesis had a higher frequency of success than the one subjected to tube thoracotomy drainage followed by pleurodesis [19].…”

Section: Discussionmentioning

confidence: 49%

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Rafei¹,

Jabak²,

Mina³

et al. 2015

Integr Cancer Sci Therap

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 49%

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Rafei¹,

Jabak²,

Mina³

et al. 2015

Integr Cancer Sci Therap

View full text Add to dashboard Cite

show abstract

“…No treatment exists, and palliative attempts may cause further morbidity and mortality (19,20). MPE was recently reclassified as a separate stage of lung cancer, since it was acknowledged to represent a distinct form of metastatic disease with very short survival (18,21,22).…”

Section: Introductionmentioning

confidence: 99%

Mast cells mediate malignant pleural effusion formation

et al. 2015

View full text Add to dashboard Cite

“…(2) Various authors have attempted to determine which pleurodesis technique is the best. Although many well-established guidelines provide general recommendations, (5)(6)(7)(8)(9) there are still a wide variety of practices. (10) The objective of the present study was to determine how pleurodesis has been performed in South and Central America.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

View full text Add to dashboard Cite

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...

show abstract

Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Cited by 35 publications

References 27 publications

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Mast cells mediate malignant pleural effusion formation

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

Contact Info

Product

Resources

About