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Management of Septated Malignant Pleural Effusions
Radhika Banka1, Dayle Terrington1,2, Eleanor K Mishra1,2
11Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, Norfolk, UK.
Current Pulmonology Reports
|March 24, 2018
Summary
Septated malignant pleural effusions indicate a poor prognosis. While fibrinolytics may reduce effusion size, they do not improve breathlessness or pleurodesis success when using chest drains for malignant pleural effusions.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Oncology
Background:
- Septated malignant pleural effusions are complex thoracic conditions.
- Management strategies for these effusions are evolving.
- Prognosis in patients with septated effusions or adhesions is often poor.
Purpose of the Study:
- To review recent studies on septated malignant pleural effusions.
- To understand the clinical implications for patient management.
- To identify evidence-based management methods for these effusions.
Main Methods:
- Systematic review of recent literature.
- Analysis of studies involving fibrinolytics in patients with septated malignant pleural effusions.
- Evaluation of radiological effusion size, breathlessness relief, and pleurodesis success.
Main Results:
- Fibrinolytics improve radiological effusion size in patients with chest drains but not breathlessness or pleurodesis success.
- The efficacy of fibrinolytics for dyspnea relief in patients with indwelling pleural catheters and septated effusions requires further assessment.
- Septated effusions and extensive adhesions are associated with a worse prognosis.
Conclusions:
- Patients with septated malignant pleural effusions generally have a poor prognosis.
- Fibrinolytics administered via chest drain do not offer clinical benefit for septated malignant pleural effusions.
- Further research is needed to clarify the role of fibrinolytics in managing septated effusions associated with indwelling pleural catheters.
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