Consensus-based standardization of procedural steps for indwelling pleural catheter placement: a modified Delphi...

Area of Science:

• Interventional Pulmonology
• Medical Device Placement
• Pleural Procedures

Background:

• Recurrent pleural effusion management often involves indwelling pleural catheters (IPCs).
• Current IPC placement techniques lack standardization, leading to practice variability.
• A need exists for consensus-based guidelines to ensure procedural safety and efficacy.

Purpose of the Study:

• To establish a consensus on the optimal technique for indwelling pleural catheter (IPC) placement.
• To develop standardized procedural steps for IPC insertion through expert agreement.
• To reduce variability in IPC placement practices among interventional pulmonologists.

Main Methods:

• A modified Delphi method was employed using a three-round online survey.
• Twenty-two experienced interventional pulmonologists in the US participated.
• Consensus was defined as an average rating score of ≥4 out of 5 for procedural steps.

Main Results:

• Consensus was reached on key aspects of IPC placement, including site selection, sterile preparation, Seldinger technique, tunneling, insertion, and securing the catheter.
• Areas of divergence included routine use of prophylactic antibiotics and intercostal artery screening with ultrasound.
• Comprehensive guidelines for IPC placement were proposed based on expert agreement.

Conclusions:

• This study provides a standardized approach for IPC placement based on expert consensus.
• The developed guidelines aim to address practice variability and enhance procedural safety.
• These consensus-based guidelines offer a foundation for future research and refinement in IPC placement techniques.