Chest

Chest

Volume 119, Issue 6, June 2001, Pages 1901-1905
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Laboratory and Animal Investigations
Talc Preparations Used for Pleurodesis Vary Markedly From One Preparation to Another

https://doi.org/10.1378/chest.119.6.1901Get rights and content

Background

At the present time, talc is the one of the agents most commonly used for the production of a pleurodesis. However, there have been several recent reports of acute pneumonitis developing after the intrapleural administration of talc. The incidence of pneumonitis has varied markedly from center to center.

Objective

To compare the physical characteristics of talc used for the production of pleurodesis in various localities.

Design

Eight talc preparations (four from the United States, and one each from Brazil, France, Spain, and Taiwan) were analyzed for the distribution of the particle size and the type and amount of impurities.

Measurements

The physical characteristics of the talc specimens were determined using radiograph diffraction and scanning electron microscopy.

Results

The mean and median particle size varied by more than a factor of three among the eight different talc preparations. In addition, the impurities of the different talc preparations were quite varied.

Conclusions

We conclude that there is marked variation in the physical characteristics of the talc preparations used intrapleurally for the production of a pleurodesis. We speculate that different incidences of acute pneumonitis at various centers after intrapleural administration of talc may be due to differences in the physical characteristics of the talc preparations used for pleurodesis.

Section snippets

Materials and Methods

Talc was obtained from four different suppliers in the United States: talc A (Sigma Chemicals; Saint Louis, MO), talc B (Malinckrodt; Chesterfield, MO), talc C (J.T. Baker; Phillipsburg, PA), and talc D (Integra Chemical; Renton, WA); and from one supplier each in Spain (Luzenac talc; Distalc; Barcelona, Spain), France (Luzenac Europe; Toulouse, France), Taiwan (Merck Taiwan LTD; Taipei, Taiwan), and Brazil (Xilolite; Sao Paulo, Brazil). The particle size distribution was determined for each

Results

There was marked variation in the distribution of the particle sizes from one talc preparation to another (Table 1) . The mean particle sized ranged from 10.8 μm for one of the talcs from the United States to > 30 μm for the talcs from France and Taiwan. Similarly, the medium particle size ranged from 7.8 μm for the one talc from the United States to 31.3 μm for the talc from France. Similar wide variations were demonstrated in the 10th and 90th percentiles for the different talcs. The

Discussion

The present study demonstrates that there is marked variation in the mean particle size from one talc preparation to another. In addition, there are also marked differences in the impurities in the various talc preparations. The differences in the incidences of respiratory distress following the intrapleural administration of talc may be due to differences in the physical characteristics of the preparations.

Talc is a pulverized, natural, sheet-like, hydrated magnesium silicate with the

ACKNOWLEDGMENT

The authors thank Dr. Ming Jeng Peng for supplying the talc from Taiwan and Dr. Francisco Vargas for supplying the talc from Brazil. The authors also thank Dr. Gary Lee, Dr. Karl Kuhn, Ms. Ada Chako-Moore, and Dr. Hassaan Mohamed for editorial assistance.

References (18)

  • JE Rinaldo et al.

    Adult respiratory distress syndrome following intrapleural instillation of talc

    Thorac Cardiovasc Surg

    (1983)
  • A Bouchama et al.

    Acute pneumonitis with bilateral effusion after talc pleurodesis

    Chest

    (1984)
  • L Kennedy et al.

    Pleurodesis using talc slurry

    Chest

    (1994)
  • JR Milanez Campos et al.

    Respiratory failure due to insufflated talc

    Lancet

    (1997)
  • DH Rehse et al.

    Respiratory failure following talc pleurodesis

    Am J Surg

    (1999)
  • D Weissberg et al.

    Talc pleurodesis: experience with 360 patients

    Thorac Cardiovasc Surg

    (1993)
  • F Rodriguez-Panadero et al.

    Pleurodesis: state of the art

    Eur Respir J

    (1997)
  • L Kennedy et al.

    Talc slurry pleurodesis: pleural fluid and histologic analysis

    Chest

    (1995)
  • EC Werebe et al.

    Systemic distribution of talc after intrapleural administration in rats

    Chest

    (1999)
There are more references available in the full text version of this article.

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Supported in part by the Saint Thomas Foundation, Nashville, TN.

Dr. Ferrer and Dr. Villarino contributed equally to the design of thestudy and writing the article.

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Copyright © 2001 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.