Randomised trial of indwelling pleural catheters for refractory transudative pleural effusions.
Eur Respir J
; 59(2)2022 02.
Article
em En
| MEDLINE
| ID: mdl-34413152
ABSTRACT
OBJECTIVE:
Refractory symptomatic transudative pleural effusions are an indication for pleural drainage. There has been supportive observational evidence for the use of indwelling pleural catheters (IPCs) for transudative effusions, but no randomised trials. We aimed to investigate the effect of IPCs on breathlessness in patients with transudative pleural effusions when compared with standard care.METHODS:
A multicentre randomised controlled trial, in which patients with transudative pleural effusions were randomly assigned to either an IPC (intervention) or therapeutic thoracentesis (TT; standard care). The primary outcome was mean daily breathlessness score over 12â weeks from randomisation.RESULTS:
220 patients were screened from April 2015 to August 2019 across 13 centres, with 33 randomised to intervention (IPC) and 35 to standard care (TT). Underlying aetiology was heart failure in 46 patients, liver failure in 16 and renal failure in six. In primary outcome analysis, the mean±sd breathlessness score over the 12-week study period was 39.7±29.4â mm in the IPC group and 45.0±26.1â mm in the TT group (p=0.67). Secondary outcomes analysis demonstrated that mean±sd drainage was 17â412±17â936â mL and 2901±2416â mL in the IPC and TT groups, respectively. A greater proportion of patients had at least one adverse event in the IPC group (p=0.04).CONCLUSION:
We found no significant difference in breathlessness over 12â weeks between IPCs or TT. TT is associated with fewer complications and IPCs reduced the number of invasive pleural procedures required. Patient preference and circumstances should be considered in selecting the intervention in this cohort.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derrame Pleural Maligno
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article