Adjunct strategies to enhance the efficacy of indwelling pleural catheters

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Malignant pleural effusion remains a distressing and unfortunately common occurrence. Pleural palliation should be focused on relieving dyspnea with as few procedures as possible. The introduction of the indwelling tunneled pleural catheter has been shown to fulfill these goals; however, it is not without limitations. The ability to potentially combine the results of a long-term pleurodesis procedure without the need for a prolonged hospitalization remains an attractive option. While no large-scale trials have been completed nor is there widespread acceptance, the introduction of “rapid” or “accelerated” pleurodesis procedures, often using tunneled indwelling pleural catheters, have the potential to significantly change the current paradigm of malignant pleural effusion management. This article reviews the current data available for “rapid” and “accelerated” pleurodesis protocols and their outcomes.

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    Conflict of interest

    Dr. Christopher Gilbert has no conflict of interest to disclose.

    Dr. David Feller-Kopman reports personal fees from CareFusion, during the conduct of the study.

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    This article does not contain any studies with human or animal subjects performed by any of the authors.

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    Correspondence to David Feller-Kopman.

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    This article is part of the Topical Collection on Pleural Diseases and Mesothelioma

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    IPC in place with Talc Poudrage (AVI 34138 kb)

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    IPC in place with Talc Poudrage (AVI 34138 kb)

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    Gilbert, C.R., Feller-Kopman, D. Adjunct strategies to enhance the efficacy of indwelling pleural catheters. Curr Pulmonol Rep 4, 28–33 (2015) doi:10.1007/s13665-015-0110-z

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    • Malignant pleural effusion
    • Pleurodesis
    • Rapid pleurodesis
    • Accelerodesis
    • Aggressive pleural drainage
    • Indwelling tunneled pleural catheter