0
Original Research: Pulmonary Procedures |

The Use of Indwelling Tunneled Pleural Catheters for Recurrent Pleural Effusions in Patients With Hematologic MalignanciesIPC Use in Hematologic Malignancies: A Multicenter Study

Christopher R. Gilbert, DO; Hans J. Lee, MD; Joseph H. Skalski, MD; Fabien Maldonado, MD, FCCP; Momen Wahidi, MD, MBA, FCCP; Philip J. Choi, MD; Jamie Bessich, MD; Daniel Sterman, MD, FCCP; A. Christine Argento, MD, FCCP; Samira Shojaee, MD, FCCP; Jed A. Gorden, MD, FCCP; Candice L. Wilshire, MD; David Feller-Kopman, MD, FCCP; Ricardo Ortiz, BS; Bareng Aletta Sanny Nonyane, PhD; Lonny Yarmus, DO, FCCP
Author and Funding Information

From the Division of Pulmonary, Allergy, and Critical Care Medicine (Dr Gilbert), Bronchoscopy and Interventional Pulmonology, Penn State College of Medicine-Milton S. Hershey Medical Center, Hershey, PA; Division of Pulmonary and Critical Care Medicine (Drs Lee, Feller-Kopman, and Yarmus and Mr Ortiz), Interventional Pulmonary, The Johns Hopkins University School of Medicine, Baltimore, MD; Division of Pulmonary and Critical Care Medicine (Drs Skalski and Maldonado), Mayo Clinic, Rochester, MN; Division of Pulmonary, Allergy, and Critical Care Medicine (Drs Wahidi and Choi), Duke University Medical Center, Durham, NC; Division of Pulmonary, Allergy, and Critical Care Medicine (Drs Bessich and Sterman), Interventional Pulmonology and Thoracic Oncology, University of Pennsylvania Medical Center, Philadelphia, PA; Division of Pulmonary, Allergy, and Critical Care Medicine (Dr Argento), Emory University Medical Center, Atlanta, GA; Division of Pulmonary and Critical Care Medicine (Dr Shojaee), Section of Interventional Pulmonology, Virginia Commonwealth University Medical Center, Richmond, VA; Division of Thoracic Surgery and Interventional Pulmonology (Drs Gorden and Wilshire), Swedish Cancer Institute, Seattle, WA; and the Department of Biostatistics (Dr Nonyane), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

CORRESPONDENCE TO: Christopher R. Gilbert, DO, Division of Pulmonary, Allergy, and Critical Care Medicine, Bronchoscopy and Interventional Pulmonology, Penn State College of Medicine-Milton S. Hershey Medical Center, Mail Code H0141, 500 University Dr, Hershey, PA 17033-0850; e-mail: cgilbert1@hmc.psu.edu


FUNDING/SUPPORT: There was no funding available for the performance of this study. The use of the REDCap database was supported by the Penn State Clinical and Translational Research Institute; a University of Pennsylvania Clinical and Translational Research Award; and a National Institutes of Health, National Center for Research Resources [Grant UL1RR033184].

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


Chest. 2015;148(3):752-758. doi:10.1378/chest.14-3119
Text Size: A A A
Published online

BACKGROUND:  Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement.

METHODS:  A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports.

RESULTS:  Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection.

CONCLUSIONS:  We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7% infection risk and 2.2% mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia often present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.

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
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543