Chest
Clinical InvestigationsCancerUse of an Implantable Pleural Catheter for Trapped Lung Syndrome in Patients With Malignant Pleural Effusion
Section snippets
Patient Population
The charts and other medical records of 11 consecutive patients who underwent pleural catheter placement between July 1998 and December 1999 for recurrent MPE with trapped lung were reviewed retrospectively. All patients who underwent evaluation and subsequent pleural catheter placement for the indication of trapped lung at the Penn Lung Center have been included. Procedures were performed under the direction of the Director of Interventional Pulmonology at our institution. The patients
Results
Details of the patients and their course and survival are summarized in Table 1. Thirteen pleural catheters were placed in 11 patients: 1 patient had large bilateral effusions and underwent bilateral pleural catheter placement; another patient required catheter revision, described below. All patients tolerated implantation of the pleural catheter uneventfully. Frequency and volume of pleural fluid drainage varied widely from patient to patient, and over time in individual patients. All patients
Discussion
The term trapped lung describes persistent atelectasis with failure of the lung to reexpand following evacuation of a chronic pleural effusion. It most commonly results from the development of a fibrous peel over the visceral pleura, in the setting of chronic pleural inflammation. An ongoing malignant process in the pleural space may also produce a thick visceral pleural peel. The peel restricts expansion of the underlying lung parenchyma, generating higher negative pleural pressures within the
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