Prolonged Non-Steroidal Anti-Inflammatory Drug Exposure After Pleurodesis Increases Pneumothorax Recurrence: A
John D L Brookes1, Andrew D Cochrane1, Julian A Smith1
1Department of Cardiothoracic Surgery, Monash Health, Clayton, Vic, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic, Australia.
Heart, Lung & Circulation
|March 8, 2024
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) do not affect pleurodesis outcomes for pneumothorax. However, prolonged NSAID use over 48 hours may increase the risk of pneumothorax recurrence.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Pharmacology
Background:
- The use of NSAIDs after pleurodesis is debated due to potential interference with the inflammatory process.
- Existing literature on NSAID use and pleurodesis outcomes is limited and inconsistent.
Purpose of the Study:
- To evaluate the impact of NSAID exposure on pleurodesis success rates and adverse events.
- To clarify the safety and efficacy of NSAIDs in patients undergoing pleurodesis for pneumothorax.
Main Methods:
- Retrospective cohort study of 147 patients who underwent pleurodesis for pneumothorax (2010-2018).
- Analysis of institutional thoracic surgery database, medical records, and imaging.
- Assessment of patient characteristics, NSAID exposure, and outcomes including recurrent pneumothorax.
Main Results:
- No significant difference in overall pleurodesis recurrence or failure rates between NSAID-exposed and non-exposed groups.
- NSAID exposure exceeding 48 hours was associated with a higher risk of recurrent pneumothorax (RR 2.16).
- No increased rate of other adverse events was observed with NSAID use.
Conclusions:
- NSAID use does not appear to compromise pleurodesis efficacy or increase adverse events.
- Prolonged NSAID administration (>48 hours) post-pleurodesis may be linked to increased recurrence rates.
- Further large-scale randomized controlled trials are needed to confirm these findings.
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