Patients were reviewed 3 days later by a specialist pleural nurse. They were assessed for lung reexpansion and resolution of effusion with thoracic ultrasound. Six areas of the hemithorax were assessed (Fig 2). When at least five areas had good pleural approximation to the chest wall, this was defined as > 90% of lung reexpansion. In the case of uncertainty, chest radiographs or CT scans were used. If the lung had not reexpanded, continued regular drainage (depending on fluid output) was advised. If the lung was fully reexpanded in five or more areas on ultrasound, and the drainage was < 200 mL/d, talc slurry was delivered through the IPC. Twenty to 25 mL 1% lignocaine was given through the IPC, along with 2.5 to 5 mg oral morphine, followed by 4 g graded talc dissolved in 50 mL normal saline, and flushed with 50 mL normal saline afterward. Patients were observed for at least 1 h following talc instillation.