Key result
Indwelling pleural catheters can be used for palliation and to achieve pleurodesis in patients with benign pleural effusions refractory to medical management.
Why the study?
Indwelling pleural catheter use is gaining popularity for benign pleural effusions refractory to medical management, but data assessing safety and efficacy across underlying etiologies needed review.
Does the use of indwelling pleural catheters improve outcomes and provide safe palliation in patients with refractory benign pleural effusions?
Does the use of indwelling pleural catheters improve outcomes and provide safe palliation in patients with refractory benign pleural effusions?
Indwelling pleural catheters offer a viable option for palliation and pleurodesis in refractory benign pleural effusions, including those caused by congestive heart failure, though infection risks must be managed.
IPCs appear safe and effective for refractory BPE in CHF; leaves open need for larger RCTs before routine adoption.
PURPOSE OF REVIEW: Benign pleural effusions (BPEs) are more common than malignant effusions and their treatment involves treating the underlying disease process. However, in cases refractory to medical management, pleural interventions might be necessary. Use of indwelling pleural catheters (IPCs) has been gaining popularity for patients with refractory effusion. In this review, we will focus on reviewing the data assessing safety and efficacy of IPC in patients with BPE related to congestive heart failure (CHF), hepatic hydrothorax, end-stage renal disease (ESRD) and chylothorax. RECENT FINDINGS: Several small studies including the most recent randomized control trial have looked into the efficacy and safety of IPC in BPE. Majority of data come from patients having CHF and hepatic hydrothorax as the underlying cause of the effusion. Limited data are available in patients with ESRD and chylothorax. Time to pleurodesis varies but is relatively higher in this patient population. Caution must be addressed in patients with immunocompromised status given a high risk of infection. SUMMARY: IPCs are increasingly being used in patients with BPE refractory to medical management. They can be used both for palliation and to achieve pleurodesis in some cases. Further data in the form of randomized control trials are still needed to evaluate the efficacy and safety of its use in this patient population.
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Atul Matta (2022) conducted a review in Benign pleural effusions. Indwelling pleural catheters was evaluated. Indwelling pleural catheters can be used for palliation and to achieve pleurodesis in patients with benign pleural effusions refractory to medical management.
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