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Ambulatory Iodopovidone Instillation Via Indwelling Pleural Catheters For Malignant Pleural Effusions
1Thoracic Surgery and Interventional Pulmonology Service, Helen F. Graham Cancer Center and Research Institute.
Abstract:
Malignant pleural effusions' (MPEs) treatment goals focus on optimizing the quality of life and decreasing time spent in health care facilities in this patient population with limited life expectancy. Numerous pleural palliation options and combination of these exist and continue to undergo studies to identify safe, superior and ideally patient-centered care. We report a cohort of 13 patients with symptomatic MPE managed with iodopovidone intrapleural instillation via an indwelling pleural catheter (IPC) in the ambulatory setting. Successful complete pleurodesis was achieved in 10 of 13 (76.9%) patients at a median time of 5 days with IPC removal at a median of 16 days. Two patient obtained partial pleurodesis with IPC removal, 1 required IPC reinsertion due to symptom recurrence. Complications were limited to intraprocedural pain in 4 patients (31%). Iodopovidone pleurodesis via IPC may represent a safe, feasible, and effective ambulatory-based option for pleural palliation in MPE.
Insights
Iodopovidone intrapleural instillation using an indwelling pleural catheter (IPC) offers an effective ambulatory treatment for malignant pleural effusions (MPEs). This approach achieved successful pleurodesis in 76.9% of patients, improving quality of life.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Oncology
Background:
- Malignant pleural effusions (MPEs) significantly impact patient quality of life due to limited life expectancy.
- Current palliative treatments for MPEs aim to improve quality of life and reduce healthcare facility time.
- Developing safe, effective, and patient-centered MPE management strategies is crucial.
Purpose of the Study:
- To evaluate the safety and efficacy of iodopovidone intrapleural instillation via an indwelling pleural catheter (IPC) for ambulatory management of symptomatic MPEs.
- To assess the complete and partial pleurodesis rates in patients treated with this method.
- To determine the complication profile and feasibility of this ambulatory MPE treatment.
Main Methods:
- A cohort of 13 patients with symptomatic MPEs was treated with iodopovidone intrapleural instillation using an IPC in an ambulatory setting.
- The indwelling pleural catheter was removed after successful pleurodesis or based on clinical judgment.
- Outcomes including pleurodesis success, time to pleurodesis, IPC dwell time, and complications were recorded.
Main Results:
- Complete pleurodesis was achieved in 10 out of 13 (76.9%) patients.
- Median time to complete pleurodesis was 5 days, with a median IPC removal time of 16 days.
- Complications were minimal, primarily intraprocedural pain in 4 patients (31%).
Conclusions:
- Ambulatory iodopovidone pleurodesis via IPC is a safe, feasible, and effective option for pleural palliation in MPE patients.
- This treatment strategy can optimize quality of life for patients with MPEs.
- Further studies may support the widespread adoption of this ambulatory MPE management technique.
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