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Laboratory and Animal InvestigationsTalc Slurry Pleurodesis: Pleural Fluid and Histologic Analysis
Section snippets
Methods
Twenty-eight New Zealand white rabbits weighing 2 to 3 kg were lightly anesthetized with 80 to 100 mg of ketamine hydrochloride (Ketalar, Parke-Davis, Morris Plains, NJ) and 0.25 mg/kg acepromazine (PromAce, Aveco, Fort Dodge, Iowa) via the lateral ear vein. The right chest wall was shaved and a 1.0-cm skin incision was made midway between the spine and scapular tip. With aseptic technique, an 18-gauge plastic catheter (Cathlon IV Striped, Critikon, Tampa, Fla) was placed percutaneously into
Pleural Fluid
Animals had a small volume of pleural fluid at 24 and 48 h following talc slurry administration (2.9 mL and 1.7 mL, respectively). There was less than 0.2 mL pleural fluid in all animals at other time points. The 24-h nucleated cell response was modest (3,300 cells per microliter) and declined on the second day. Neutrophils were the predominant cell at 24 h (56%) while monocytes and macrophages were predominant by 48 h. Pleural fluid pH ranged from 7.38 to 7.48. Pleural fluid was exudative with
Discussion
Talc as a slurry, as opposed to talc insufflation, has been criticized as a method of administration for pleurodesis because of nonuniform distribution in the pleural space. We considered that a better understanding of the mechanisms of talc pleurodesis would be helpful in resolving the issue of route of administration. Therefore, we analyzed pleural fluid and gross and histologic pathologic findings in an animal model to better characterize the mechanisms of pleural symphysis.
Early work by
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2012, Journal of the American College of SurgeonsCitation Excerpt :Three animal studies have examined systemic distribution of talc after pleurodesis. Kennedy and colleagues53 demonstrated distribution of talc to multiple lymph nodes as well as spleen, lung, and kidney, with associated localized inflammatory reactions. Werebe and associates43 also used a small particle talc and found talc particles in 100% of organs in all rats harvested at 24 and 48 hours.
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revision accepted December 15.