Related Experiment Video
Updated: Jul 3, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Management of malignant pleural effusions.
Marcelo Spector1, Jeffrey S Pollak
1Section of Vascular and Interventional Radiology, Department of Radiology, Yale University School of Medicine, New Haven, Connecticut 06520-8042, USA.
Seminars in Respiratory and Critical Care Medicine
|July 25, 2008
Summary
Malignant pleural effusions (MPEs) management can be improved with tunneled pleural drainage catheters. These catheters offer effective symptom control for outpatients with MPE, particularly those with lung or breast cancer.
Area of Science:
- Pulmonology
- Oncology
- Thoracic Surgery
Background:
- Malignant pleural effusions (MPEs) are common complications of advanced cancers, notably lung and breast cancer.
- Management strategies for MPEs are tailored to patient status, symptom severity, and primary tumor response.
- Initial diagnostic and therapeutic interventions often involve thoracentesis.
Purpose of the Study:
- To evaluate the efficacy and advantages of long-term tunneled pleural drainage catheters for managing malignant pleural effusions.
- To compare tunneled catheters with traditional chest tube placement and sclerotherapy.
- To identify patient populations that would benefit most from outpatient management of MPEs.
Main Methods:
- Review of management strategies for malignant pleural effusions.
- Comparison of outcomes between chest tube placement with sclerotherapy and tunneled pleural drainage catheters.
- Analysis of patient selection criteria for outpatient MPE management.
Main Results:
- Chest tube placement with sclerotherapy has a 60-90% success rate but requires ~1 week hospitalization.
- Tunneled pleural drainage catheters provide symptom control in 80-100% of outpatients.
- Tunneled catheters can manage complex effusions (trapped lung, loculated, bilateral) and may lead to spontaneous pleurodesis in up to 50% of patients.
Conclusions:
- Tunneled pleural drainage catheters are a highly effective outpatient option for managing malignant pleural effusions.
- These catheters offer advantages in treating complex effusions and potentially reducing healthcare costs.
- Consideration of tunneled catheters is recommended for all MPE patients, especially those suitable for outpatient care.
Related Concept Videos
01:28Pleural Effusion II: Symptoms and Management
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:25Pleural Effusion I: Introduction
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
01:30Pneumonia V: Nursing management and Prevention
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:30Pleural Disorders: Types and Brief Description
The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:
01:13Pleura of the Lungs
The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...