Study objectives: We describe a series of patients with
symptomatic, refractory malignant pleural effusion (MPE) and underlying
trapped lung syndrome who underwent placement of a small-bore, flexible
indwelling pleural catheter for home drainage of recurrent MPE.
Design: The medical records of 11 consecutive patients who
underwent pleural catheter placement for MPE with trapped lung syndrome
were reviewed retrospectively.
Setting: Patients were
evaluated and followed up in the Pulmonary Outpatient Practice at the
Hospital of the University of Pennsylvania.
Nine men and two women with underlying malignancies including lung
cancer, lymphoma, and mesothelioma underwent pleural catheter
Interventions: Thirteen pleural catheters
were placed in 11 patients, all under local anesthesia. Patients
received detailed instructions for drainage and catheter care. They
were reevaluated weekly for the first 2 weeks, and then as clinically
indicated. Patients typically performed pleural drainage at home up to
1,000 mL two or three times weekly.
results: All patients reported symptomatic benefit, defined as
improved dyspnea and exercise tolerance, except for one patient. In 10
patients, the pleural catheters remained in place until death, for 15
to 234 days. The mean length of placement was 115 days. One patient
required revision after catheter occlusion. Other complications
included catheter infection, localized skin breakdown, and possible
Conclusion: We have described a series of
patients with MPE and trapped lung syndrome for whom placement of a
permanent pleural catheter provided a convenient, effective alternative
to the procedures currently in use. Our patients reported good
symptomatic relief following catheter placement with few major