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Management of Indwelling Tunneled Pleural Catheters: A Modified Delphi Consensus Statement.
Gilbert, Christopher R; Wahidi, Momen M; Light, Richard W; Rivera, M Patricia; Sterman, Daniel H; Thomas, Rajesh; Shojaee, Samira; Shoham, Shmuel; Psallidas, Ioannis; Ost, David E; Molena, Daniela; Maskell, Nick; Maldonado, Fabien; Liberman, Moishe; Lee, Y C Gary; Lee, Hans; Herth, Felix J F; Grosu, Horiana; Gorden, Jed A; Fysh, Edward T H; Corcoran, John P; Argento, A Christine; Akulian, Jason A; Rahman, Najib M; Yarmus, Lonny B.
Afiliación
  • Gilbert CR; Department of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA. Electronic address: christopher.gilbert@swedish.org.
  • Wahidi MM; Division of Pulmonary and Critical Care, Duke University, Durham, NC.
  • Light RW; Division of Allergy, Pulmonary and Critical Care, Vanderbilt University, Nashville, TN.
  • Rivera MP; Division of Pulmonary and Critical Care, University of North Carolina, Chapel Hill, NC.
  • Sterman DH; Division of Pulmonary, Critical Care and Sleep Medicine, New York University, New York, NY.
  • Thomas R; Department of Respiratory Medicine, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.
  • Shojaee S; Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, VA.
  • Shoham S; Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD.
  • Psallidas I; Centre for Respiratory Medicine, University College London, London, England.
  • Ost DE; Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Molena D; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Maskell N; Academic Respiratory Unit, University of Bristol Medical School, Bristol, England.
  • Maldonado F; Division of Allergy, Pulmonary and Critical Care, Vanderbilt University, Nashville, TN.
  • Liberman M; Division of Thoracic Surgery, Department of Surgery, University of Montreal, Montreal, Quebec, Canada.
  • Lee YCG; Department of Respiratory Medicine, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.
  • Lee H; Division of Pulmonary and Critical Care, Johns Hopkins School of Medicine, Baltimore, MD.
  • Herth FJF; Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.
  • Grosu H; Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Gorden JA; Department of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA.
  • Fysh ETH; Department of Respiratory Medicine, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.
  • Corcoran JP; Department of Respiratory Medicine, University Hospitals Plymouth NHS Trust, Plymouth, England.
  • Argento AC; Division of Pulmonary and Critical Care, Northwestern University, Chicago, IL.
  • Akulian JA; Division of Pulmonary and Critical Care, University of North Carolina, Chapel Hill, NC.
  • Rahman NM; Oxford Centre for Respiratory Medicine, Churchill Hospital, University of Oxford, Oxford, England, and Oxford NIHR Biomedical Research Centre.
  • Yarmus LB; Division of Pulmonary and Critical Care, Johns Hopkins School of Medicine, Baltimore, MD.
Chest ; 158(5): 2221-2228, 2020 11.
Article en En | MEDLINE | ID: mdl-32561437
ABSTRACT

BACKGROUND:

The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) because of their effectiveness and ease of outpatient placement. However, with the increase in IPC placement there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. RESEARCH QUESTION Our objective was to formulate clinical consensus statements related to perioperative and long-term IPC catheter management based on a modified Delphi process from experts in pleural disease management. STUDY DESIGN AND

METHODS:

Expert panel members used a modified Delphi process to reach consensus on common perioperative and long-term management options related to IPC use. Members were identified from multiple countries, specialties, and practice settings. A series of meetings and anonymous online surveys were completed. Responses were used to formulate consensus statements among panel experts, using a modified Delphi process. Consensus was defined a priori as greater than 80% agreement among panel constituents.

RESULTS:

A total of 25 physicians participated in this project. The following topics were addressed during the process definition of an IPC infection, management of IPC-related infectious complications, interventions to prevent IPC infections, IPC-related obstruction/malfunction management, assessment of IPC removal, and instructions regarding IPC management by patients and caregivers. Strong consensus was obtained on 36 statements. No consensus was obtained on 29 statements.

INTERPRETATION:

The management of recurrent pleural disease with IPC remains complex and challenging. This statement offers statements for care in numerous areas related to IPC management based on expert consensus and identifies areas that lack consensus. Further studies related to long-term management of IPC are warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derrame Pleural / Catéteres de Permanencia / Pleurodesia / Consenso Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Chest Año: 2020 Tipo del documento: Article
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derrame Pleural / Catéteres de Permanencia / Pleurodesia / Consenso Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Chest Año: 2020 Tipo del documento: Article