Clinical Case Database / Category: Practical Procedure
Chemical pleurodesis: what is it and how to do it
Publication details
A Gondker MRCP, S Pathmanathan MRCP, JA Kastelik MD FRCP
Foundation Years Journal, volume 5, issue 9, p.88 (123Doc Education, London, October 2011)
Abstract
Bedside medical pleurodesis is a procedure that is performed to prevent re-occurrence of pleural fluid. Medical pleurodesis is usually performed in the context of patients with recurrent pleural effusion due to underlying malignancy. The procedure involves instillation of an agent such as Talc into the pleural space. The aim of the procedure is to prevent pleural fluid from recurring by artificial obliteration of the pleural space through creation of an adhesion between the parietal and visceral pleura. The common complications of pleurodesis include pain, fever and occasionally potentially fatal respiratory failure due to pneumonitis or adult respiratory distress syndrome. It is important that the procedure and its complications are carefully explained to the patient and documented in the medical notes. Currently medical bedside pleurodesis carries a success rate of approximately 80%. Alternative procedures that allow for pleurodesis to be performed, which carry much higher rate of success but are also more invasive, include medical thoracoscopy and video-assisted thoracoscopic surgery (VATS).
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Authors
A Gondker MRCP
Department of Respiratory Medicine
Hull University, Hull York Medical School
Castle Hill Hospital
Castle Road
Cottingham
East Yorkshire HU16 5JQ
S Pathmanathan MRCP
Department of Respiratory Medicine
Hull University, Hull York Medical School
Castle Hill Hospital
Castle Road
Cottingham
East Yorkshire HU16 5JQ
JA Kastelik MD FRCP
Department of Respiratory Medicine
Hull University, Hull York Medical School
Castle Hill Hospital
Castle Road
Cottingham
East Yorkshire HU16 5JQ
jack.kastelik@hey.nhs.uk
References
1. Roberts M, Neville E, Berrisford R, et al. British Thoracic Society. Management of Malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65(Suppl 2):ii32-ii40.
2. Shaw PHS, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002916. DOI: 10.1002/14651858.CD002916.pub2. Available from: URL http://www.cochrane.org.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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