Seguridad de la pleurodesis con polvo de talco en el derrame pleural maligno: un estudio de cohorte prospectivo
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Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
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Julius P Janssen1, Gareth Collier1, Phillippe Astoul2
1Canisius Wilhelmina Hospital, Nijmegen, Netherlands.
Lancet (London, England)
|May 8, 2007
Resumen
El talco de partículas grandes es un tratamiento seguro y eficaz para el derrame pleural maligno, sin casos de síndrome de dificultad respiratoria aguda reportados. Este estudio confirma su seguridad para los procedimientos de pleurodesis.
Área de la Ciencia:
- Pulmonología Pulmonología.
- Oncología Oncología.
Sus antecedentes:
- El talco es un agente de pleurodesis altamente eficaz para el derrame pleural maligno.
- Existen preocupaciones con respecto al riesgo de síndrome de dificultad respiratoria aguda (SRDA) (1-9%) con talco intrapleural.
- Investigar la seguridad del talco de partículas grandes es crucial.
Objetivo del estudio:
- Evaluar la seguridad del uso de talco de partículas grandes para la pleurodesis en pacientes con derrame pleural maligno.
- Para determinar la incidencia de la ERAD después de la pulverización de talco.
Principales métodos:
- Un estudio de cohorte multicéntrico y prospectivo en el que participaron 558 pacientes con derrame pleural maligno.
- Los pacientes se sometieron a una toracoscopia y a una extracción de talco en polvo utilizando 4 g de talco francés calibrado de partículas grandes.
- El criterio de valoración primario fue la aparición de ARDS después de la pleurodesis.
Principales resultados:
- Ningún paciente desarrolló ARDS (0% de incidencia).
- 11 pacientes (2%) murieron dentro de los 30 días.
- Siete pacientes (1,2%) experimentaron complicaciones no fatales, incluido un caso de insuficiencia respiratoria.
Conclusiones:
- El uso de talco de partículas grandes para la pleurodesis en el derrame pleural maligno es seguro.
- El talco de partículas grandes no está asociado con el desarrollo de ARDS.
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