The impact of pleurodesis in malignant effusion on respiratory function.

Pleurodesis of malignant pleural effusion provides for a substantially better quality of life compared to onging exudation with the need for repeated evacuation of fluid. Successful pleurodesis leads to permanent cessation of fluid production as a result of the formation of fibrous adhesion between the lung and costal pleura which in theory, however, might restrict lung mobility. In patients with poor lung function, or with need for bilateral pleurodesis, the apprehension of further impairment of lung function often arises. The aim of this study was to evaluate the effects of pleurodesis on lung function. Therefore 10 patients with malignant pleurisy with very limited tumour were investigated. They were without radiological signs of tumour infiltration in the lung parenchyma, without visible tumour growth in the pleural space during thoracoscopy and had undergone a successful one-sided pleurodesis. Respiratory function tests were performed at different times, 1-102 months after pleurodesis. The assessment consisted of: static and dynamic spirometry, exercise testing with blood gas determination and radiospirometry. Spirometric values were slightly low, but in general within the reference limits. Blood gas determination showed no signs of alveolar hypoventilation. Radiospirometry showed a slight attenuation of activity in the treated lung but similar turnover of gas of the treated vs. the untreated side. The study showed that pleurodesis in malignant pleurisy has only minor impact on respiratory function.

Quinacrine-induced pleural inflammation in malignant pleurisy: relation between drainage time of pleural fluid and local interleukin-1 beta levels.

In this study, the levels of interleukin-1 beta (IL-1 beta) were measured in pleural fluid from patients with chronic malignant pleural effusions, before and during quinacrine-induced pleurodesis. IL-1 beta levels increased significantly within 24 h after the instillation of quinacrine (p < 0.001). The levels of IL-1 beta correlated with the amount of pleural fluid production as well as with the tube drainage treatment time. Thus, the more IL-1 beta levels increased the higher pleural fluid production was seen and a longer drainage treatment time was needed. There were no correlations between IL-1 beta levels and degree of fever, recruitment of pleural leucocytes, activity of pleural coagulation or inhibition of pleural fibrinolysis.