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Adverse events after pleurodesis in patients with malignant pleural effusion
Ricardo Mingarini Terra1, Priscila Berenice da Costa1, Alberto Jorge Monteiro Dela Vega2
1Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil.
Background:
Malignant pleural effusion (MPE) is an important sign of advanced disease in metastatic cancer. Pleurodesis is one option to treat recurrent MPE. The Inflammatory response after pleurodesis may lead to important adverse events (AE) in a set of very ill patients.
Methods:
Retrospective analysis of patients submitted to pleurodesis (2009-2013). Clinical and laboratory data were collected. We compare the values in the day of pleurodesis, 2nd, 5th and 10th days after.
Results:
One hundred fourteen patients were undergone to pleurodesis with silver nitrate (46%), iodine (52%) and talc (2%). Female was the most frequent (86%) and the breast cancer was the most common primary site. The most frequent adverse event was low hemoglobin account (37), followed by pain (31). 68% of patients presented AEs and 28% had at least one AE with grade 3 or higher. The most altered was CRP that peaked in the 5th day after pleurodesis. Changes in CRP curve were less severe with the use of iodine when compared with the other two agents.
Conclusions:
Pleurodesis leads to important systemic inflammatory response detected by different serum markers. The occurrence of adverse events in this set of patients was great number of events with being marked as grade 3 or higher.
Insights
Pleurodesis for malignant pleural effusion causes a significant inflammatory response and adverse events, particularly low hemoglobin and pain. Iodine may be associated with less severe inflammatory marker changes compared to other agents.
Area of Science:
- Oncology
- Pulmonology
- Critical Care Medicine
Background:
- Malignant pleural effusion (MPE) indicates advanced metastatic cancer.
- Pleurodesis is a treatment for recurrent MPE.
- Post-pleurodesis inflammatory response can cause adverse events in critically ill patients.
Purpose of the Study:
- To analyze the systemic inflammatory response and adverse events following pleurodesis.
- To compare inflammatory markers and adverse events based on pleurodesis agents.
Main Methods:
- Retrospective analysis of 114 patients undergoing pleurodesis (2009-2013).
- Collection and comparison of clinical and laboratory data pre-pleurodesis and on days 2, 5, and 10 post-procedure.
- Evaluation of adverse events and their severity.
Main Results:
- Silver nitrate (46%), iodine (52%), and talc (2%) were used. Breast cancer was the most common primary site.
- The most frequent adverse events were low hemoglobin (37%) and pain (31%).
- 68% of patients experienced adverse events, with 28% having grade 3 or higher. C-reactive protein (CRP) peaked on day 5, with less severe changes observed with iodine.
Conclusions:
- Pleurodesis induces a notable systemic inflammatory response, evidenced by serum markers.
- Adverse events are common following pleurodesis, with a significant proportion being severe (grade 3+).
- Iodine may be associated with a milder inflammatory response compared to silver nitrate and talc.
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