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Audit, research and guideline update
Indwelling pleural catheters for non-malignant effusions: a multicentre review of practice
  1. Rahul Bhatnagar1,
  2. Elaine D Reid2,
  3. John P Corcoran3,
  4. Jessamy D Bagenal4,
  5. Sandra Pope5,
  6. Amelia O Clive1,
  7. Natalie Zahan-Evans1,
  8. Peter O Froeschle6,
  9. Douglas West4,
  10. Najib M Rahman3,7,
  11. Sumit Chatterji2,
  12. Pasupathy R Sivasothy2,
  13. Nick A Maskell1
  1. 1Academic Respiratory Unit, University of Bristol, Bristol, UK
  2. 2Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
  4. 4Department of Thoracic Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  5. 5Lung Cancer Clinical Nurse Specialist, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  6. 6Department of Thoracic Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  7. 7Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
  1. Correspondence to Dr Nick A Maskell, Academic Respiratory Unit, University of Bristol, Second Floor, Learning and Research Building, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK; nick.maskell{at}bristol.ac.uk

Abstract

Indwelling pleural catheters (IPCs) are commonly used in the management of malignant pleural effusion (MPE). There is little data on their use in non-malignant conditions. All IPC insertions for non-malignant cases from five large UK centres were found using prospectively maintained databases. Data were collected on 57 IPC insertions. The commonest indications were hepatic hydrothorax (33%) and inflammatory pleuritis (26%). The mean weekly fluid output was 2.8 L (SD 2.52). 48/57 (84%) patients had no complications. Suspected pleural infection was documented in 2 (3.5%) cases. 33% (19/57) of patients underwent ‘spontaneous’ pleurodesis at a median time of 71 days. Patients with hepatic disease achieved pleurodesis significantly less often than those with non-hepatic disease (p=0.03). These data support the use of IPCs in select cases of non-malignant disease when maximal medical therapy has failed.

  • Pleural Disease
  • Empyema

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