0
Original Research: Pulmonary Procedures |

Use of Indwelling Pleural Catheters for Cardiogenic Pleural EffusionsManagement of Cardiogenic Pleural Effusions

Nadim Srour, MD; Rajini Potechin, MD; Kayvan Amjadi, MD
Author and Funding Information

From the Université de Sherbrooke (Dr Srour), Sherbrooke, QC; Hôpital Charles-LeMoyne (Dr Srour), Greenfield Park, QC; Ottawa Hospital Research Institute (Drs Srour and Amjadi), Ottawa, ON; Faculty of Medicine (Drs Potechin and Amjadi), University of Ottawa, Ottawa, ON; and the Department of Medicine (Drs Potechin and Amjadi), The Ottawa Hospital, Ottawa, ON, Canada.

Correspondence to: Nadim Srour, MD, Hôpital Charles-LeMoyne, 3120 Blvd Taschereau, Greenfield Park, QC, J4V 2H1, Canada; e-mail: nadim.srour@usherbrooke.ca


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(5):1603-1608. doi:10.1378/chest.13-0331
Text Size: A A A
Published online

Background:  Cardiogenic pleural effusions are rarely refractory to treatment of the underlying disease. Few options are available in these cases. Indwelling pleural catheter (IPC) insertion has been well described for the management of malignant pleural effusions. We present our experience with using IPCs for cardiogenic pleural effusion management.

Methods:  We prospectively constructed a cohort of patients who underwent IPC insertion for cardiogenic pleural effusions. Patients were carefully selected, and the IPCs were inserted as a palliative measure or while awaiting cardiac transplantation.

Results:  There were 43 IPCs inserted in 38 patients. Patients had significant dyspnea, with a mean baseline dyspnea index of 2.24 (95% CI, 1.53-2.94). There was significant improvement in dyspnea 2 weeks after IPC insertion, with a mean transitional dyspnea index of 6.19 (95% CI, 5.56-6.82). There was no occurrence of empyema. Pneumothorax, mostly ex vacuo, occurred in 11.6% of procedures but did not require further intervention. IPCs were removed in 18 patients (47.4%), and successful spontaneous pleurodesis occurred in 11 patients (29.0%) after a median of 66 days (interquartile range, 34-242 days). Patients who eventually had their catheters removed had better performance status (P = .008) and were less dyspneic (P = .005) at baseline and had longer survival (P < .0001).

Conclusions:  IPC insertion for cardiogenic pleural effusion is a feasible option in carefully selected patients. Further research is needed to confirm the results and to assess the impact of IPC insertion on the quality of life of these patients.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543