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Conference Paper: Large volume drainage of malignant pleural effusions: risks and benefits

TitleLarge volume drainage of malignant pleural effusions: risks and benefits
Authors
KeywordsMedical sciences
Respiratory diseases medical sciences
Cardiovascular diseases
Issue Date2010
PublisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
Citation
The 2010 Annual Scientific Meeting of the American College of Chest Physicians (CHEST 2010), Vancouver, BC., Canada, 30 October-4 November 2010. In Chest, 2010, v. 138 n. 4_meeting abstracts, p. 345A How to Cite?
AbstractPURPOSE: To prevent Re-expansion Pulmonary Edema (RPE) when draining malignant pleural effusions (MPEs), the maximum drainage on a single occasion has often been arbitrarily limited to 1L. Few studies have addressed the potential risks and benefits of draining larger volumes. METHODS: Seventy-four consecutive patients with large, symptomatic MPEs received chest tube insertion by a Cardiothoracic Surgery unit. At the surgeon’s discretion, maximum daily drainage in 32 patients (43%) was limited to 1L. Drainage volumes, clinical progress and serial chest X-rays were assessed for all patients. RESULTS: In the first hour, the mean volume drained in this cohort overall was 773ml, and over 1L was drained in 30 patients (41%). No patient developed clinical or radiographical RPE as defined by established diagnostic criteria. Five patients (6.8%) developed self-limiting coughing for less than 20 minutes, but no association with initial drainage of over 1L was observed (p=0.32). No other drainage-related complications were experienced by any patient. In patients for whom no maximum daily drainage limit was set, within 24 hours symptomatic improvement was noted in 93% and complete resolution of the MPE on chest X-ray was observed in 40%. This compares to 84% and 28% respectively in those who had limits set, although the differences fell short of statistical significance. In 65 patients for whom chemical pleurodesis was planned at the time of chest tube insertion, the mean interval between tube insertion and pleurodesis was significantly shorter in patients for whom no maximum daily drainage limit was set (4.1 days versus 5.8 days, p=0.04). CONCLUSION: For large, symptomatic MPEs, drainage of 1L or more in a single sitting appears to be safe.
DescriptionCase Reports
Open Access Journal
Persistent Identifierhttp://hdl.handle.net/10722/214114
ISSN
2015 Impact Factor: 5.94
2015 SCImago Journal Rankings: 3.176

 

DC FieldValueLanguage
dc.contributor.authorSihoe, ADL-
dc.contributor.authorYam, NLH-
dc.date.accessioned2015-08-20T07:33:03Z-
dc.date.available2015-08-20T07:33:03Z-
dc.date.issued2010-
dc.identifier.citationThe 2010 Annual Scientific Meeting of the American College of Chest Physicians (CHEST 2010), Vancouver, BC., Canada, 30 October-4 November 2010. In Chest, 2010, v. 138 n. 4_meeting abstracts, p. 345A-
dc.identifier.issn0012-3692-
dc.identifier.urihttp://hdl.handle.net/10722/214114-
dc.descriptionCase Reports-
dc.descriptionOpen Access Journal-
dc.description.abstractPURPOSE: To prevent Re-expansion Pulmonary Edema (RPE) when draining malignant pleural effusions (MPEs), the maximum drainage on a single occasion has often been arbitrarily limited to 1L. Few studies have addressed the potential risks and benefits of draining larger volumes. METHODS: Seventy-four consecutive patients with large, symptomatic MPEs received chest tube insertion by a Cardiothoracic Surgery unit. At the surgeon’s discretion, maximum daily drainage in 32 patients (43%) was limited to 1L. Drainage volumes, clinical progress and serial chest X-rays were assessed for all patients. RESULTS: In the first hour, the mean volume drained in this cohort overall was 773ml, and over 1L was drained in 30 patients (41%). No patient developed clinical or radiographical RPE as defined by established diagnostic criteria. Five patients (6.8%) developed self-limiting coughing for less than 20 minutes, but no association with initial drainage of over 1L was observed (p=0.32). No other drainage-related complications were experienced by any patient. In patients for whom no maximum daily drainage limit was set, within 24 hours symptomatic improvement was noted in 93% and complete resolution of the MPE on chest X-ray was observed in 40%. This compares to 84% and 28% respectively in those who had limits set, although the differences fell short of statistical significance. In 65 patients for whom chemical pleurodesis was planned at the time of chest tube insertion, the mean interval between tube insertion and pleurodesis was significantly shorter in patients for whom no maximum daily drainage limit was set (4.1 days versus 5.8 days, p=0.04). CONCLUSION: For large, symptomatic MPEs, drainage of 1L or more in a single sitting appears to be safe.-
dc.languageeng-
dc.publisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org-
dc.relation.ispartofChest-
dc.subjectMedical sciences-
dc.subjectRespiratory diseases medical sciences-
dc.subjectCardiovascular diseases-
dc.titleLarge volume drainage of malignant pleural effusions: risks and benefits-
dc.typeConference_Paper-
dc.identifier.emailSihoe, ADL: adls1@hku.hk-
dc.identifier.authoritySihoe, ADL=rp01889-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1378/chest.9877-
dc.identifier.hkuros247043-
dc.identifier.hkuros247085-
dc.identifier.volume138-
dc.identifier.issue4_meeting abstracts-
dc.identifier.spage345A-
dc.identifier.epage345A-
dc.publisher.placeUnited States-

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