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Indwelling pleural catheter

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https://www.readbyqxmd.com/read/29629920/pleural-effusions-in-hematologic-malignancies-and-their-management-with-indwelling-pleural-catheters
#1
Erik Vakil, Carlos A Jimenez, Saadia A Faiz
PURPOSE OF REVIEW: Pleural effusions in patients with hematologic malignancy may represent malignant pleural effusion (MPE) or occur secondary to infection, treatment effects, and other common causes. The impact of MPE on prognosis in this cohort remains unclear. Indwelling pleural catheters (IPCs) are routinely placed for palliation of recurrent symptomatic MPEs, but perceived concerns over infection and bleeding may limit their use in patients with hematologic malignancies. However, recent evidence suggests IPCs are both well tolerated and effective in this cohort...
April 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29617585/outpatient-talc-administration-by-indwelling-pleural-catheter-for-malignant-effusion
#2
RANDOMIZED CONTROLLED TRIAL
Rahul Bhatnagar, Emma K Keenan, Anna J Morley, Brennan C Kahan, Andrew E Stanton, Mohammed Haris, Richard N Harrison, Rehan A Mustafa, Lesley J Bishop, Liju Ahmed, Alex West, Jayne Holme, Matthew Evison, Mohammed Munavvar, Pasupathy Sivasothy, Jurgen Herre, David Cooper, Mark Roberts, Anur Guhan, Clare Hooper, James Walters, Tarek S Saba, Biswajit Chakrabarti, Samal Gunatilake, Ioannis Psallidas, Steven P Walker, Anna C Bibby, Sarah Smith, Louise J Stadon, Natalie J Zahan-Evans, Y C Gary Lee, John E Harvey, Najib M Rahman, Robert F Miller, Nick A Maskell
BACKGROUND: Malignant pleural effusion affects more than 750,000 persons each year across Europe and the United States. Pleurodesis with the administration of talc in hospitalized patients is the most common treatment, but indwelling pleural catheters placed for drainage offer an ambulatory alternative. We examined whether talc administered through an indwelling pleural catheter was more effective at inducing pleurodesis than the use of an indwelling pleural catheter alone. METHODS: Over a period of 4 years, we recruited patients with malignant pleural effusion at 18 centers in the United Kingdom...
April 5, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29607152/wet-m1a-non-small-cell-lung-cancer-is-it-possible-to-predict-recurrence-of-pleural-effusion
#3
Fernando Conrado Abrao, Igor Renato Louro Bruno de Abreu, Geisa Garcia Viana, Mariana Campello de Oliveira, Elnara Marcia Negri, Riad Naim Younes
Background: The propose was to recognize risk factors of malignant pleural effusion (MPE) recurrence in patients with symptomatic M1a non-small cell lung cancer (NSCLC). Methods: All patients with NSCLC and MPE submitted to pleural palliative procedures were enrolled in a prospective study. Group I contained patients who had pleural recurrence, and Group II with no pleural recurrence. Prognostic factors for pleural recurrence were identified by univariable analysis, using Fisher's exact test for categorical variables and Student's t test for quantitative variables...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29568725/management-of-septated-malignant-pleural-effusions
#4
REVIEW
Radhika Banka, Dayle Terrington, Eleanor K Mishra
Purpose of Review: We review recent studies of patients with septated malignant pleural effusions, to understand what the clinical implications for patients are and what evidence-based methods should be used to manage these effusions. Recent Findings: Fibrinolytics improve effusion size assessed radiologically in patients with a chest drain inserted for septated malignant pleural effusions but this does not translate into an improvement in breathlessness relief or pleurodesis success...
2018: Current Pulmonology Reports
https://www.readbyqxmd.com/read/29512239/the-changing-vista-of-pleural-effusion-management-indwelling-pleural-catheters-ipc
#5
Sarah Jane Messeder, Mahendran Chetty, Megan C Thomson, Graeme P Currie
No abstract text is available yet for this article.
March 7, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29507795/endoscopic-diagnosis-and-management-of-pleural-effusion-in-malignant-pleural-mesothelioma
#6
REVIEW
Paolo Ceruti, Sara Lonni, Francesca Baglivo, Giampietro Marchetti
Malignant pleural mesothelioma (MPM) is an asbestos-related aggressive tumor, that requires proper diagnosis and management. Symptoms are nonspecific and chest computed tomography (CT) and chest ultrasound (US) are important radiological tools in the initial workup to identify early pathological signs. Performing a medical thoracoscopy (MT) is essential for a definitive diagnosis of MPM. The procedure, integrated with a prior US, allows a global evaluation of the pleural cavity and the execution of multiple targeted biopsies, with low risk of complications...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29478341/the-role-of-pleurodesis-in-respiratory-diseases
#7
Rachel M Mercer, Maged Hassan, Najib M Rahman
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice...
April 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29433714/malignant-pleural-effusion-from-diagnostics-to-therapeutics
#8
REVIEW
Rachelle Asciak, Najib M Rahman
Malignant pleural effusion is a common complication of cancer and denotes a poor prognosis. It usually presents with dyspnea and a unilateral large pleural effusion. Thoracic computed tomography scans and ultrasound are helpful in distinguishing malignant from benign effusions. Pleural fluid cytology is diagnostic in about 60% of cases. In cytology-negative disease, pleural biopsies are helpful. Current management is palliative. Previously, first-line treatment for recurrent symptomatic malignant pleural effusion was chest drain insertion and talc pleurodesis, with indwelling pleural catheter insertion reserved for patients with trapped lung or failed talc pleurodesis...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29388816/bilateral-indwelling-pleural-catheters-for-pleural-effusions-secondary-to-nonmalignant-superior-vena-cava-obstruction
#9
David M Ferraro, Shawn K French, David G Bell
No abstract text is available yet for this article.
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29372629/chest-tube-drainage-of-the-pleural-space-a-concise-review-for-pulmonologists
#10
REVIEW
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
April 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29346248/the-utility-of-ultrasound-to-diagnose-tunnel-tract-infection-related-to-indwelling-pleural-catheters
#11
Jose Cardenas-Garcia, Neal Fitzpatrick, George Z Cheng
Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29325199/-efficacy-and-safety-of-indwelling-pleural-catheters
#12
Eva Lücke, Uwe Steffen, Sandra Riedel, Jens Schreiber
In symptomatic malignant pleural effusions, mostly in a palliative situation, therapeutic procedures should be chosen to improve dyspnoea and the concomitant impairment of quality of life. Indwelling pleural catheters (IPC) have played an increasing role in recent years. The efficacy and safety of this method have not been adequately clarified under real-life clinical conditions. 94 patients, in whom IPC had been implanted because of a clinical indication, were analysed retrospectively with respect to efficacy and safety, together with patient characteristics, peri- and postinterventional complications, e...
January 11, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#13
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
January 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29230111/letter-to-the-editor-catheter-track-metastasis-with-indwelling-pleural-catheter
#14
Sara Zank, Elham Abboud, Wissam Jaber, Abdul Hamid Alraiyes
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#15
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29199894/local-and-systemic-effects-of-a-silver-nitrate-coated-indwelling-pleural-catheter-in-an-animal-model-of-pleurodesis
#16
Alain Tremblay, Christine T Kearney, Chris Hanks, Jennifer Hughes Hanks, David S White, Marcia E Pereira, Craig E Zook, Karen Sargis, Luke Zhang
Purpose/Aim of the study: This study assessed the safety and potential toxicity of a silver nitrate coated indwelling pleural catheter (SNCIPC) designed to create pleurodesis in a large animal model. MATERIALS AND METHODS: Sixteen animals underwent insertion of either a SNCIPC or an uncoated silicone catheter. Half of the animals were sacrificed at day 7 and the others at day 30. Animal weight and assessment of well-being, pleural fluid and blood collection were performed at regular intervals...
November 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29164255/effect-of-an-indwelling-pleural-catheter-vs-talc-pleurodesis-on-hospitalization-days-in-patients-with-malignant-pleural-effusion-the-ample-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29150040/management-of-malignant-lung-entrapment-the-oncothorax
#18
REVIEW
Roman Petrov, Charles Bakhos, Abbas E Abbas
Pleural metastasis is a common occurrence in up to 30% of patients with metastatic cancer. When lung entrapment and loculation of fluid occur, treatment is more difficult and we have named this condition "oncothorax." The malignant adhesions that entrap the lung in an oncothorax are not typically amenable to surgical decortication. The standard approach for managing these patients is to place an indwelling catheter. Other options may include pleurectomy and decortication, intrapleural hyperthermic chemoperfusion, and intrapleural photodynamic therapy...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29119067/experience-with-ambulatory-management-of-pleural-pathologies-utilizing-small-bore-indwelling-pleural-catheters
#19
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29111830/surgical-and-non-surgical-management-of-malignant-pleural-effusions
#20
Deirdre B Fitzgerald, Coenraad F N Koegelenberg, Kazuhiro Yasufuku, Y C Gary Lee
Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias...
January 2018: Expert Review of Respiratory Medicine
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