Original article
Use of Indwelling Pleural Catheter in the Outpatient Management of Recurrent Malignant Pleural Effusion
Uso del drenaje pleural permanente en el manejo ambulatorio del derrame pleural maligno recidivante
Enrique Casesa,
, Luis Seijob, Carlos Disdierc, María José Lorenzoa, Rosa Cordovillad, Francisca Sanchisa, Marimar Lacunzab, Gregoria Sevillanoc, Fátima Benito-Sendínd
Corresponding author
a Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain
b Departamento de Neumología, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
c Sección de Neumología, Hospital San Pedro de Alcántara, Centro de Investigaciones Biomédicas en Red (CIBER) de Enfermedades Respiratorias, Cáceres, Spain
d Servicio de Neumología, Hospital Universitario Salamanca, Salamanca, Spain
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Hospital Universitario Salamanca, Salamanca, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso del drenaje pleural permanente en el manejo ambulatorio del derrame pleural maligno recidivante" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-05-01" "fechaAceptado" => "2009-09-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec155544" "palabras" => array:3 [ 0 => "Malignant pleural effusion" 1 => "Indwelling catheter" 2 => "Outpatient" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155545" "palabras" => array:3 [ 0 => "Derrame pleural maligno" 1 => "Catéter pleural tunelizado permanente" 2 => "Paciente ambulatorio" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">To analyse the effectiveness and safety of the indwelling pleural catheter in the management of recurrent malignant pleural effusion.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A prospective multicentre study was performed in 63 consecutive outpatients from four Spanish hospitals. A total of 43 men and 20 women were included, with a median age of 67 years. In seven of the cases treatment with pleurodesis had failed; in five other cases their lung was trapped; in another five cases after repeat therapeutic thoracocentesis, and the rest of them as a preference choice to pleurodesis. All patients had an indwelling pleural catheter inserted (PleurX<span class="elsevierStyleSup">®</span>, Denver Biomedical).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Most of patients (94.5%) reported an improvement in their respiratory symptoms (cough and dyspnoea) and their ability to function independently. Average length of the catheterisation was 45 days (6-222). Average amount of drained pleural effusion was 75 ml, with a frequency of drainage of between 3 and 4 times per week and once fortnightly. Spontaneous pleurodesis was achieved following 34.9% of procedures. No complications occurred during the insertion of the catheter. The post-catheterisation complications were empyema (3 cases), chest pain (2 cases), and tumour metastasis (3 cases).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The use of an indwelling pleural catheter is an effective palliative treatment in the outpatient management for patients suffering malignant pleural effusion. It is also a simple treatment that can be easily applied, does not require hospitalisation and can be easily managed by the patient at home, with a low rate of complications.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El objetivo del estudio ha sido analizar la eficacia y seguridad del catéter de drenaje pleural permanente en el manejo de pacientes con diagnóstico de derrame pleural maligno.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio prospectivo y multicéntrico de 63 pacientes consecutivos de 4 hospitales españoles. Se incluyó a 43 varones y 20 mujeres, con una mediana de edad de 67 años, diagnosticados de derrame pleural maligno sintomático. En 7 casos el tratamiento se indicó tras fracaso de pleurodesis, en 5 por encontrarse el pulmón atrapado, en otros 5 tras toracocentesis repetidas y en el resto como indicación preferente a la pleurodesis. A todos los pacientes se les insertó de forma ambulatoria un catéter tunelizado permanente (PleurX<span class="elsevierStyleSup">®</span>, Denver Biomedical).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La mayoría de los pacientes (95,4%) refirió mejoría parcial o completa de los síntomas respiratorios (tos y disnea) y de su capacidad funcional. La mediana de duración de uso del catéter fue de 45 días (rango: 6-222). La mediana diaria de líquido pleural drenado fue de 75 ml. En 22 casos (34,9%) se produjo una pleurodesis espontánea. No se registraron complicaciones durante la inserción del catéter. Las complicaciones durante el seguimiento fueron las siguientes: empiema (3 casos), dolor torácico (2 casos) y diseminaciones del tumor por el lugar de inserción del tubo (3 casos).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El catéter de drenaje pleural permanente es eficaz en el manejo ambulatorio del paciente con derrame pleural maligno sintomático. Es un procedimiento sencillo que no precisa ingreso hospitalario, de fácil manejo para el paciente en su domicilio y con escasas complicaciones.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Survival and talc pleurodesis in metastatic pleural carcinoma, revisited. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 6 | 11 |
| 2024 October | 30 | 14 | 44 |
| 2024 September | 31 | 14 | 45 |
| 2024 August | 50 | 39 | 89 |
| 2024 July | 25 | 24 | 49 |
| 2024 June | 30 | 22 | 52 |
| 2024 May | 39 | 31 | 70 |
| 2024 April | 20 | 24 | 44 |
| 2024 March | 20 | 19 | 39 |
| 2024 February | 22 | 18 | 40 |
| 2024 January | 0 | 2 | 2 |
| 2023 March | 2 | 5 | 7 |
| 2023 February | 10 | 18 | 28 |
| 2023 January | 20 | 25 | 45 |
| 2022 December | 23 | 23 | 46 |
| 2022 November | 12 | 15 | 27 |
| 2022 October | 29 | 35 | 64 |
| 2022 September | 18 | 17 | 35 |
| 2022 August | 16 | 37 | 53 |
| 2022 July | 22 | 35 | 57 |
| 2022 June | 20 | 30 | 50 |
| 2022 May | 16 | 33 | 49 |
| 2022 April | 18 | 23 | 41 |
| 2022 March | 22 | 37 | 59 |
| 2022 February | 15 | 16 | 31 |
| 2022 January | 16 | 36 | 52 |
| 2021 December | 16 | 43 | 59 |
| 2021 November | 27 | 49 | 76 |
| 2021 October | 18 | 58 | 76 |
| 2021 September | 13 | 63 | 76 |
| 2021 August | 25 | 38 | 63 |
| 2021 July | 18 | 34 | 52 |
| 2021 June | 24 | 41 | 65 |
| 2021 May | 10 | 29 | 39 |
| 2021 April | 17 | 61 | 78 |
| 2021 March | 17 | 35 | 52 |
| 2021 February | 11 | 18 | 29 |
| 2021 January | 8 | 17 | 25 |
| 2020 December | 14 | 16 | 30 |
| 2020 November | 12 | 13 | 25 |
| 2020 October | 15 | 11 | 26 |
| 2020 September | 17 | 20 | 37 |
| 2020 August | 10 | 15 | 25 |
| 2020 July | 15 | 22 | 37 |
| 2020 June | 5 | 15 | 20 |
| 2020 May | 9 | 25 | 34 |
| 2020 April | 16 | 13 | 29 |
| 2020 March | 14 | 19 | 33 |
| 2020 February | 22 | 19 | 41 |
| 2020 January | 20 | 25 | 45 |
| 2019 December | 21 | 32 | 53 |
| 2019 November | 15 | 25 | 40 |
| 2019 October | 8 | 26 | 34 |
| 2019 September | 15 | 37 | 52 |
| 2019 August | 12 | 23 | 35 |
| 2019 July | 14 | 24 | 38 |
| 2019 June | 7 | 28 | 35 |
| 2019 May | 10 | 19 | 29 |
| 2019 April | 47 | 24 | 71 |
| 2019 March | 16 | 20 | 36 |
| 2019 February | 14 | 15 | 29 |
| 2019 January | 13 | 7 | 20 |
| 2018 December | 9 | 15 | 24 |
| 2018 November | 18 | 22 | 40 |
| 2018 October | 21 | 12 | 33 |
| 2018 September | 16 | 11 | 27 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 16 | 7 | 23 |
| 2018 March | 5 | 1 | 6 |
| 2018 February | 5 | 8 | 13 |
| 2018 January | 6 | 11 | 17 |
| 2017 December | 4 | 7 | 11 |
| 2017 November | 6 | 9 | 15 |
| 2017 October | 10 | 14 | 24 |
| 2017 September | 5 | 8 | 13 |
| 2017 August | 25 | 19 | 44 |
| 2017 July | 21 | 6 | 27 |
| 2017 June | 22 | 15 | 37 |
| 2017 May | 15 | 6 | 21 |
| 2017 April | 27 | 4 | 31 |
| 2017 March | 14 | 5 | 19 |
| 2017 February | 14 | 5 | 19 |
| 2017 January | 6 | 2 | 8 |
| 2016 December | 8 | 7 | 15 |
| 2016 November | 17 | 8 | 25 |
| 2016 October | 11 | 3 | 14 |
| 2016 September | 7 | 6 | 13 |
| 2016 August | 6 | 2 | 8 |
| 2016 July | 8 | 4 | 12 |
| 2016 May | 1 | 0 | 1 |
| 2016 March | 10 | 0 | 10 |
| 2016 February | 4 | 0 | 4 |
| 2016 January | 6 | 0 | 6 |
| 2015 December | 5 | 0 | 5 |
| 2015 October | 151 | 19 | 170 |
| 2015 September | 146 | 10 | 156 |
| 2015 August | 132 | 11 | 143 |
| 2015 July | 168 | 13 | 181 |
| 2015 June | 140 | 18 | 158 |
| 2015 May | 152 | 21 | 173 |
| 2015 April | 122 | 11 | 133 |
| 2015 March | 163 | 7 | 170 |
| 2015 February | 188 | 8 | 196 |
| 2015 January | 124 | 7 | 131 |
| 2014 December | 116 | 9 | 125 |
| 2014 November | 106 | 5 | 111 |
| 2014 October | 171 | 11 | 182 |
| 2014 September | 272 | 9 | 281 |
| 2014 August | 363 | 9 | 372 |
| 2014 July | 309 | 10 | 319 |
| 2014 June | 167 | 12 | 179 |
| 2014 May | 131 | 11 | 142 |
| 2014 April | 114 | 7 | 121 |
| 2014 March | 119 | 15 | 134 |
| 2014 February | 122 | 19 | 141 |
| 2014 January | 119 | 11 | 130 |
| 2013 December | 112 | 7 | 119 |
| 2013 November | 81 | 6 | 87 |
| 2013 October | 99 | 6 | 105 |
| 2013 September | 90 | 15 | 105 |
| 2013 August | 70 | 9 | 79 |
| 2013 July | 103 | 13 | 116 |
| 2013 June | 85 | 5 | 90 |
| 2013 May | 78 | 8 | 86 |
| 2013 April | 60 | 4 | 64 |
| 2013 March | 14 | 2 | 16 |
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