PleurX catheters provide symptomatic relief of dyspnea related to recurrent pleural effusions. Little is known about long term outcome and outpatient complications.
Twenty-one consecutive patients were reviewed. Collected data included demographics, site, underlying disorder, length of time with catheter, time to pleurodesis, hospital admissions, caretaker, frequency of drainage, concurrent therapies and complications. Procedures were done in standard fashion using ultrasound guidance by a member of the Interventional Pulmonary section.
3 catheters were never used and therefore time related data does not include these patients. 80% of the catheters were placed as outpatient procedures,10% bedside, and 10% in the operating room during planned thoracic procedures. 28% of the patients achieved autopleurodesis in an average of 72 days. 61% used the catheter for symptom relief until their death. The longest currently is 315 days. The average length of time with a catheter was 105 days (r 17-315d). 81% of the catheters were placed in oncology patients, 94% with malignant effusions and 6% graft versus host disease. 47% of patients had concurrent chemotherapy or combination chemotherapy/radiation therapy while using PleurX. The referral base shows the nature of multidisciplinary approach to care. 66% of patients were referred by oncology, 5% thoracic surgery, 5% cardiology, and 24% pulmonary. In 100% of the cases, family members were trained by the RN as caretakers. Following education, return demonstration was necessary for competence. There were no complications with the placement or use of the catheter. 2 patients required 1 MD visit and otherwise care was RN driven. 5%(1 patient) were admitted to the hospital for effusion. This was directly related to inappropriate use of the catheter at the outside facility.
In patients and families undergoing a structured teaching program, long term drainage catheters are well tolerated for a variety of underlying disorders and associated with very few complications.
PleurX catheters present an excellent option in the long-term care care of patients with recurrent effusions.
L.M. Smith, None.