Tunneled Pleural Catheter Placement with and without Talc Poudrage for Treatment of Pleural Effusions Due to Congestive Heart Failure

Majid, Adnan; Kheir, Fayez; Fashjian, Meghan; Chatterji, Sumit; Fernández-Bussy, Sebastián; Ochoa, Sebastian; Cheng, George; Folch, Erik

doi:10.1513/annalsats.201507-471bc

Cited by 31 publications

(10 citation statements)

References 18 publications

(21 reference statements)

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“…In a prospective study of 24 patients with HH, Chen et al [29] have shown that the use of indwelling pleural catheters (IPCs) with a regimented drainage schedule of 1 L fluid removal on every other day may be a feasible and safe approach. Although IPCs are often used in the management and palliation of malignant pleural effusion [30][31][32], a growing body of literature proves their utility and safety in benign pleural effusions [29,[33][34][35]. However, this is paired with an overall higher complication rate and lower spontaneous pleurodesis rate in the HH population receiving IPCs compared to malignant pleural effusion [29,36].…”

Section: Discussionmentioning

confidence: 99%

Repeat Thoracentesis in Hepatic Hydrothorax and Non-Hepatic Hydrothorax Effusions: A Case-Control Study

et al. 2018

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Background: Repeat thoracentesis for symptom control is offered to patients with refractory hepatic hydrothorax (HH) but the risk profile for this management strategy remains unclear. Objectives: This study aimed to compare complication frequency and nature during repeat thoracentesis in patients with and without HH. Methods: Complication rates in patients undergoing repeat thoracentesis for symptom relief was compared between patients with HH and a control group (non-HH group) at a single center from 2010 to 2015. Records were reviewed for demographics, laboratory values, number of thoracentesis, and associated complications with each procedure. Results: 82 patients with HH (274 thoracenteses) and 100 control patients (188 thoracenteses) were included. A complication was noted in 17/462 (0.03%) procedures in the entire cohort. There was a higher overall complication rate with repeat thoracentesis in the HH group (8 vs. 0%, p = 0.016, 95% CI = 1.5–14.6). In the HH group, the cumulative risk of complications increased with sequential thoracenteses; a complication occurring in the preceding intervention was the strongest predictor for subsequent complication (OR = 17.1, p = 0.0013) and more than 1 previous complication was associated with a 15-fold increased risk of a subsequent complication (p < 0.001). In multivariate analysis within the HH group, the Model for End-Stage Liver Disease (MELD) score was an independent predictor of hemothorax (OR = 1.19, 95% CI = 1.03–1.36, p = 0.012). Conclusions: Repeat thoracentesis is an overall low-risk procedure, although a higher complication rate is observed in HH compared with non-HH patients. The presence of a previous complication significantly increases the risk of future complications in the HH population.

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Section: Discussionmentioning

confidence: 99%

Repeat Thoracentesis in Hepatic Hydrothorax and Non-Hepatic Hydrothorax Effusions: A Case-Control Study

et al. 2018

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“…IPC is not well studied, although a retrospective series suggest that IPC alone may only achieve a 25% success rate, which improves to 80% only with the addition of talc poudrage. 89 With so many therapeutic options available, pleurodesis (chemical and IPC) has generally been selected when maximal medical management is insufficient to control pleural effusion-related symptoms.…”

Section: Pleurodesis For Nonmalignant Effusionmentioning

confidence: 99%

Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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Symptomatic pleural disease, specifically malignant pleural effusion, refractory benign pleural effusion, and pneumothoraces are common diseases that often require therapeutic interventions. The spectrum of management strategies often includes selection of a chemical pleurodesis agent administered in combination with an indwelling pleural catheter or chest tube.Additionally, there is a role for minimally invasive techniques which include medical thoracoscopy or more advanced video-assisted thoracoscopic approaches. Ongoing clinical trials continue to evolve best practices regarding the optimal sclerosant agents and procedural approaches in the management of these diseases.

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“…Критерии Лайта остаются золотым стандартом дифференциальной диагностики экссудата и транссудата более 30 лет. Однако в ходе терапии диуретиками количество белка и ЛДГ в транссудате увеличивается [20]. Поэтому у пациентов с сердечной недостаточностью критерии Лайта следует дополнить уровнем альбумина (>1,2 г/дл) и мозгового натрийуритического пептида [22], у пациентов с циррозом печени -отношением альбуминов плевральной жидкости к альбуминам крови (<0,6) [21].…”

Section: типичные жалобы и анамнез при плевральных выпотахunclassified