You are here

  • Home
  • Archive
  • Volume 7, Issue 1
  • Indwelling pleural catheters for non-malignant pleural effusions: report on a single centre’s 10 years of experience

Article Text

Article menu

Download PDFPDF

XML
Pleural Disease
Indwelling pleural catheters for non-malignant pleural effusions: report on a single centre’s 10 years of experience
  1. Nikolaj Frost1,
  2. Christoph Ruwwe-Glösenkamp1,
  3. Matthias Raspe1,
  4. Martin Brünger2,
  5. Bettina Temmesfeld-Wollbrück1,
  6. Norbert Suttorp1 and
  7. Martin Witzenrath1,3
  1. 1Department of Infectious Diseases and Pulmonary Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
  2. 2Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt- Universität zu Berlin, and Berlin Institute of Health, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany, Charité Universitätsmedizin Berlin, Berlin, Germany
  3. 3Division of Pulmonary Inflammation, Charíté-Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to Dr Nikolaj Frost; nikolaj.frost{at}charite.de

Abstract

Background Recurrent pleural effusion is a common cause of dyspnoea, cough and chest pain during the course of infectious pleurisy and non-malignant diseases like congestive heart failure (CHF) or liver cirrhosis with hepatic hydrothorax (HH). With regard to the chronic character of the underlying diseases, indwelling pleural catheters (IPC) are increasingly used, not only assuring immediate symptom relief but also potentially leading to pleurodesis without sclerosing agents.

Patients and methods In this single-centre retrospective observational study, patient characteristics, procedural variables and outcome in patients with IPC in non-malignant pleural effusion (NMPE) were evaluated and prognostic factors for pleurodesis were identified.

Results From 2006 to 2017, 54 patients received 62 IPC, of whom 48.4% with CHF and 43.5% with HH. The median length of insertion was 1.5 months (IQR 0.6–2.9 months), the median survival time after insertion 3.2 months (IQR 1.1–16.0). An adequate symptom relief was achieved in 93.2% with no need for subsequent interventions. In patients surviving ≥30 days after IPC insertion, pleurodesis was observed in 45.9%, being associated to age (<55 years, p=0.02), the primary diagnosis (p=0.03) and interventions for the underlying disease (p<0.001). Complications occurred in 24.2% of all procedures (n=15), the majority concerning mechanical obstructions (n=10) and infections (n=4). Patients with HH had an excess risk for complications (37.3%).

Conclusion Efficacy in symptom relief and a generally manageable safety profile recommend IPC as a first-line treatment option in NMPE, where disease-specific treatments are exhausted. Caution is warranted in patients with HH due to an excess risk for complications.

  • pleural disease
  • palliative care
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2019-000501

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors NF designed the study and assembled the data set. NF and MB analysed the data. All authors contributed to the interpretation of the results. NF and MB organised the drafting of the manuscript. All authors contributed to the writing of the manuscript and approved the final version.

    • Funding We acknowledge support from the German Research Foundation (DFG) and the Open Access Publication Funds of Charité – Universitätsmedizin Berlin

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Approval for the study was obtained from the Charité – Universitätsmedizin Berlin ethics committee (EA2/037/18).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request. Deidentified participant data are available on reasonable request as an SPSS file from the corresponding author.