Indwelling pleural catheter: Management of complications

Document Type

Journal Article

Publication Title

Seminars in Respiratory and Critical Care Medicine

PubMed ID

37257836

Publisher

Thieme

School

School of Medical and Health Sciences

RAS ID

60256

Funders

Medical Research Future Fund of Australia

Comments

Sidhu, C., Davies, H. E., Muruganandan, S., Lui, M. M. S., Lau, E. P. M., & Lee, Y. C. G. (2023). Indwelling pleural catheter: Management of complications. Seminars in Respiratory and Critical Care Medicine, 44(04), 454-461. https://doi.org/10.1055/s-0043-1769093

Abstract

Multiple randomized clinical trials have established the advantages of indwelling pleural catheter (IPC) in the management of malignant pleural effusions, resulting in its widespread adoption in clinical practice. Complications can occur with IPC use and must be recognized and managed effectively. This review provides a comprehensive overview of IPC complications and their best care. Pain postinsertion or during drainage of IPC is easily manageable and must be distinguished from tumor-related chest wall pain. IPC-related infections require systemic antibiotics and often intrapleural fibrinolytic/deoxyribonuclease therapy. The removal of IPC for infection is usually unnecessary. Symptomatic loculation usually responds to fibrinolytics but may recur. Catheter tract metastases are common in mesothelioma patients and usually respond to radiotherapy without inducing damages to the IPC. Less common complications include dislodgement, irreversible blockage, and fractures (upon removal) of the catheter. Recommendations on the management of IPC complications by recent consensus statement/guideline are discussed. Expert opinions on management approaches are included in areas where evidence is lacking to guide care.

DOI

10.1055/s-0043-1769093

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