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Inflammatory parameters after pleurodesis in recurrent malignant pleural effusions and their predictive value
Valiant Ukale1, Veronica Agrenius, Olle Widström
1Department of Medicine, Thoracic Clinics, Karolinska Sjukhuset, Stockholm S-171 76, Sweden. valiant.ukale@ks.se
Respiratory Medicine
|December 14, 2004
Summary
Pleurodesis for malignant pleural effusion induces a systemic inflammatory response. Higher fever and inflammatory markers like CRP after the procedure correlate with successful pleurodesis, not infection.
Area of Science:
- Pulmonology
- Oncology
- Inflammation Research
Background:
- Recurrent malignant pleural effusion is a common clinical challenge.
- Pleurodesis, inducing pleural symphysis, is a standard treatment.
- The relationship between systemic inflammation and pleurodesis outcomes requires further investigation.
Purpose of the Study:
- To characterize the systemic inflammatory reaction post-pleurodesis.
- To determine if inflammatory markers predict pleurodesis success.
- To differentiate inflammatory response from infection.
Main Methods:
- Prospective study of 89 patients undergoing pleurodesis with talc or quinacrine.
- Monitoring of erythrocyte sedimentation rate, C-reactive protein (CRP), and leukocyte count.
- Assessment of fever response at 8 and 48 hours post-procedure.
Main Results:
- Pleurodesis resulted in a significant systemic inflammatory response in 92% of patients.
- Successful pleurodesis showed a tendency towards correlation with higher inflammatory parameters.
- Fever at 8 and 48 hours was a statistically significant indicator of success.
Conclusions:
- Pleurodesis reliably induces a systemic inflammatory response.
- The degree of inflammation, particularly fever, may predict pleurodesis success.
- Elevated inflammatory markers post-pleurodesis indicate the procedure's effect, not necessarily infection.
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