Use of Peritoneal Catheters for Patients Receiving Palliative Care

Introduction to interventional radiology's role in palliative care for children with cancer: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

“…[45][46][47] Indwelling tunneled, cuffed, drainage catheters (ITCs), instead, offer patients a long-term option for at-home palliative management of their malignant effusions in both adults and children. 46,[48][49][50] These catheters, in children, are placed with imaging guidance, and can be placed in both the inpatient and outpatient settings under conscious sedation or general anesthesia (Figure 3). The most commonly used ITCs are PleurX (BD, Franklin Lakes, NJ) catheters (Figure 4) and Tenckhoff catheters (Medtronic, Dublin, Ireland), although the latter is more specifically designed for peritoneal dialysis rather than peritoneal drainage.…”

“…51 Comparatively, the adult literature examining the efficacy and safety of ITCs for malignant effusions in adults is more robust, but further supports ITCs as an efficacious and safe palliative option for these patients that facilitates discharge from the inpatient setting in appropriate clinical scenarios. [46][47][48][49][50] When pediatric oncologists and palliative care teams have patients with malignant effusions, either pleural or peritoneal, it is important to remember that interventional radiologists may be able to place ITCs to help facilitate discharge to home for these children.…”

“…However, pleurodesis is associated with prolonged hospitalization, severe pain, and worsening fluid loculations 45–47 . Indwelling tunneled, cuffed, drainage catheters (ITCs), instead, offer patients a long‐term option for at‐home palliative management of their malignant effusions in both adults and children 46,48–50 . These catheters, in children, are placed with imaging guidance, and can be placed in both the inpatient and outpatient settings under conscious sedation or general anesthesia (Figure 3).…”

“…Comparatively, the adult literature examining the efficacy and safety of ITCs for malignant effusions in adults is more robust, but further supports ITCs as an efficacious and safe palliative option for these patients that facilitates discharge from the inpatient setting in appropriate clinical scenarios 46–50 …”