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Thoracic Ultrasound as an Early Predictor of Pleurodesis Success in Malignant Pleural Effusion.
Chest. 2018 Sep 19;:
Authors: Corcoran JP, Hallifax RJ, Mercer RM, Yousuf A, Asciak R, Hassan M, Piotrowska HE, Psallidas I, Rahman NM
Abstract
Malignant pleural effusion (MPE) is common and imposes a significant burden on patients and health care providers. Most patients require definitive treatment, such as drainage and chemical pleurodesis, to prevent fluid and symptom recurrence. Thoracic ultrasound (TUS) can identify pleural adhesions in other clinical scenarios, and might therefore predict long-term pleurodesis success in MPE. Eighteen patients undergoing chest tube drainage and talc slurry instillation for MPE underwent TUS examination immediately before and 24 hours after talc instillation to derive pleural adherence scores for the affected hemithorax. Two independent assessors blinded to the patient's clinical status additionally scored recorded TUS scans. Participants who suffered pleurodesis failure had a lower adherence score at 24 h post-talc instillation than those who were successful (difference, 6.27; 95% CI, 3.94-8.59). A TUS-derived pleural adherence score may predict long-term outcomes following chemical pleurodesis. Further research is needed to evaluate this novel finding.
PMID: 30243566 [PubMed - as supplied by publisher]