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Indications to Perform a Pleurodesis in a Patient with Lung Cancer and a Malignant Pleural Effusion

Description

Pleurodesis can provide significant palliative relief for a patient with lung cancer and a malignant pleural effusion. It involves placement of an irritant chemical into the pleural space. This elicits an inflammatory response and extensive fibrosis between the visceral and parietal pleura, obliterating the pleural space.


 

Patient selection: lung cancer with malignant pleural effusion

 

The ideal candidate for pleurodesis has:

(1) a poor quality of life caused by symptoms associated with the pleural effusion, especially dyspnea

(2) had improvement in clinical symptoms following thoracentesis

(3) a better performance status (Karnofsky performance status >= 70)

(4) an expected survival for several months

(5) favorable biochemical findings in the pleural fluid (pH >= 7.20, LDH <= 600 IU/L, glucose >= 60 mg/dL)

 

Agents used for chemical pleurodesis include:

(1) talc

(2) doxycycline

(3) ethanol

 


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