Document Type
Journal Article
Publication Title
Internal Medicine Journal
Volume
54
Issue
7
First Page
1119
Last Page
1125
PubMed ID
38560767
Publisher
Wiley
School
School of Medical and Health Sciences / Exercise Medicine Research Institute
RAS ID
69900
Funders
National Health & Medical Research Council
Abstract
Background: Malignant pleural effusions (MPEs) are common, and a third of them have underlying trapped lung (TL). Management of MPE and TL is suspected to be heterogeneous. Understanding current practices in Australasia is important in guiding policies and future research. Aims: Electronic survey of Australia-New Zealand respiratory physicians, thoracic surgeons and their respective trainees to determine practice of MPE and TL management. Results: Of the 132 respondents, 56% were respiratory physicians, 23% were surgeons and 20% were trainees. Many respondents defined TL as >25% or any level of incomplete lung expansion; 75% would use large-volume thoracentesis to determine whether TL was present. For patients with TL, indwelling pleural catheters (IPCs) were the preferred treatment irrespective of prognosis. In those without TL, surgical pleurodesis was the most common choice if prognosis was >6 months, whereas IPC was the preferred option if survival was <3 months. Only 5% of respondents considered decortication having a definite role in TL, but 55% would consider it in select cases. Forty-nine per cent of surgeons would not perform decortication when the lung does not fully expand intra-operatively. Perceived advantages of IPCs were minimisation of hospital time, effusion re-intervention and usefulness irrespective of TL status. Perceived disadvantages of IPCs were lack of suitable drainage care, potentially indefinite duration of catheter-in-situ and catheter complications. Conclusion: This survey highlights the lack of definition of TL and heterogeneity of MPE management in Australasia, especially for patients with expandable lungs. This survey also identified the main hurdles of IPC use that should be targeted.
DOI
10.1111/imj.16366
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Comments
Sidhu, C., Wright, G., Peddle‐McIntyre, C. J., Tan, A. L., & Lee, Y. C. G. (2024). Management of malignant pleural effusion and trapped lung: a survey of respiratory physicians and thoracic surgeons in Australasia. Internal Medicine Journal, 54(7), 1119-1125. https://doi.org/10.1111/imj.16366