Perspectives on Periplacement Management of Tunneled Pleural Catheters

Background: Indwelling tunneled pleural catheters (IPC) have transformed the management of malignant pleural effusions, offering outpatient placement and symptom relief without the need for repeated invasive procedures. Despite their widespread adoption and expansion to nonmalignant effusion management, practice patterns widely vary, and very little is described in the literature regarding patient education practices. Methods: A cross-sectional survey was distributed via the American Association for Bronchology and Interventional Pulmonology (AABIP). The survey assessed demographics, procedural volume, placement techniques, and follow-up practices. Descriptive statistics characterized IPC practices. Results: Among 104 respondents, IPCs were most commonly placed in procedure suites (81.8%). Local anesthesia was the most frequently used method (51.6%). Infection prevention strategies varied, with 94.4% using sterile barriers beyond the kit-provided drape and 24.7% administering IV antibiotics. Advanced Practice Providers (APPs) were involved in IPC management in 44.4% of practices, mainly for troubleshooting (87.8%) and patient education (78%), though less commonly for placement (22%). Patient education was provided in 95.7% of cases, typically by proceduralists (33.7%) or nurses (49.4%), using commercial videos (58.4%) and printed materials (57.3%). Conclusion: Despite the widespread use of IPCs, variability in placement, patient education, and follow-up remains. Standardized guidelines and research focusing on patient-centered outcomes, education strategies, and home care models are needed to optimize IPC management.