Abstract | STUDY OBJECTIVE: DESIGN: Prospective case series. SETTING: Two university hospital programs. PATIENTS: INTERVENTIONS: A 14F catheter was inserted percutaneously into the pleural space after radiographic confirmation of free fluid by lateral decubitus views. Following radiographic confirmation of complete fluid evacuation, a sclerosing agent (ie, talc slurry or bleomycin) was instilled into the pleural space. This was accomplished within 2 h of chest tube insertion, unless the tube was inserted in the evening or if the lung was trapped. After clamping the tube for 90 min, the pleural space was drained for 2 h, after which the chest tube was removed. The intervention was scored as "successful" if no radiographic evidence of fluid reaccumulation was noted at 4 weeks. A "partial successful" score indicated reaccumulation of fluid that did not produce symptoms and did not require repeat pleural drainage of any sort. All other outcomes were scored as "unsuccessful." MEASUREMENTS AND RESULTS: Forty chest tubes were inserted into 38 patients. Four procedures revealed the presence of a trapped lung and did not result in any attempt at pleurodesis. Five patients who received pleurodesis died in less than 1 month and therefore were not evaluable. Two patients had technical problems with the chest tube and were not evaluable. Of the remaining 29 procedures, drainage procedures with pleurodesis were performed in 27 patients, a complete response was seen in 14 patients (48%), a partial response was seen in 9 patients (31%), and 6 patients (21%) did not respond to pleurodesis. Chemical pleurodesis was completed as an outpatient procedure in only two patients. In one of these, the outcome was unsuccessful. In the remainder, insertion of the chest tube in the evening or additional medical problems necessitated hospital admission, but the entire procedure was completed within 24 h. CONCLUSIONS:
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Authors | Peter A Spiegler, Adam N Hurewitz, Maritza L Groth |
Journal | Chest
(Chest)
Vol. 123
Issue 6
Pg. 1895-8
(Jun 2003)
ISSN: 0012-3692 [Print] United States |
PMID | 12796165
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Chest Tubes
- Humans
- Intubation
- Pleural Effusion, Malignant
(diagnostic imaging, therapy)
- Pleurodesis
(adverse effects, methods)
- Prospective Studies
- Radiography
- Sclerosing Solutions
(administration & dosage)
- Treatment Outcome
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