[Use of indwelling pleural catheter in the outpatient management of recurrent malignant pleural effusion].
OBJECTIVE
To analyse the effectiveness and safety of the indwelling pleural catheter in the management of recurrent malignant pleural effusion.


METHODS
A prospective multicentre study was performed in 63 consecutive outpatients from four Spanish hospitals. A total of 43 men and 20 women were included, with a median age of 67 years. In seven of the cases treatment with pleurodesis had failed; in five other cases their lung was trapped; in another five cases after repeat therapeutic thoracocentesis, and the rest of them as a preference choice to pleurodesis. All patients had an indwelling pleural catheter inserted (PleurX), Denver Biomedical).


RESULTS
Most of patients (94.5%) reported an improvement in their respiratory symptoms (cough and dyspnoea) and their ability to function independently. Average length of the catheterisation was 45 days (6-222). Average amount of drained pleural effusion was 75ml, with a frequency of drainage of between 3 and 4 times per week and once fortnightly. Spontaneous pleurodesis was achieved following 34.9% of procedures. No complications occurred during the insertion of the catheter. The post-catheterisation complications were empyema (3 cases), chest pain (2 cases), and tumour metastasis (3 cases).


CONCLUSIONS
The use of an indwelling pleural catheter is an effective palliative treatment in the outpatient management for patients suffering malignant pleural effusion. It is also a simple treatment that can be easily applied, does not require hospitalisation and can be easily managed by the patient at home, with a low rate of complications.
Cases
Enrique
E
Servicio de Neumología, Hospital Universitario La Fe, Valencia, España. cases_enr@gva.es
Seijo
Luis
L
Disdier
Carlos
C
Lorenzo
María José
MJ
Cordovilla
Rosa
R
Sanchis
Francisca
F
Lacunza
Marimar
M
Sevillano
Gregoria
G
Benito-Sendín
Fátima
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence