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Published on: November 10, 2023
Indwelling Pleural Catheter Placement for Nonmalignant Pleural Effusions
Kyle Bramley1, Erin DeBiasi1, Jonathan Puchalski1
1Division of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.
Abstract:
Pleural effusions account for significant symptoms and morbidity. Recent studies demonstrate a high mortality in patients with "benign" pleural effusions, now better characterized as nonmalignant pleural effusions (NMPEs) based on their prognosis. The most common nonmalignant clinical conditions with recurrent pleural effusions are congestive heart failure and hepatic hydrothorax, although many other diseases exist in isolation or as comorbid conditions. When conventional therapy fails, thoracentesis is often performed for relief of dyspnea. Many times, however, the effusions recur despite maximal medical therapy. Placement of tunneled or indwelling pleural catheters provides an effective therapeutic strategy for recurrent NMPEs when other medical therapy fails.
Insights
Nonmalignant pleural effusions (NMPEs) can cause severe symptoms and high mortality. Indwelling pleural catheters offer an effective treatment for recurrent NMPEs when conventional therapies fail.
Area of Science:
- Pulmonology
- Internal Medicine
Background:
- Pleural effusions cause significant morbidity and mortality.
- Nonmalignant pleural effusions (NMPEs) are increasingly recognized for their poor prognosis.
- Common causes include congestive heart failure and hepatic hydrothorax.
Purpose of the Study:
- To review the management of recurrent nonmalignant pleural effusions.
- To highlight therapeutic options when conventional medical therapy is insufficient.
Main Methods:
- Review of recent studies on pleural effusions.
- Discussion of clinical conditions associated with NMPEs.
- Evaluation of thoracentesis and pleural catheter placement.
Main Results:
- Recurrent NMPEs often persist despite maximal medical therapy.
- Thoracentesis provides temporary relief but effusions frequently recur.
- Indwelling pleural catheters are an effective strategy for managing refractory recurrent NMPEs.
Conclusions:
- Nonmalignant pleural effusions require careful management.
- Indwelling pleural catheters represent a valuable therapeutic option for patients with recurrent NMPEs unresponsive to other treatments.
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