Monitoring Response to Pleurodesis for Malignant Pleural Effusion in a Patient with Lung Cancer

 

Assessment is usually performed several weeks after the procedure.

Clinical Finding	Response
no fluid reaccumulation with resolution of symptoms	complete
minor fluid reaccumulation with or without minor symptoms OR significant decrease in need for thoracentesis	partial
rapid fluid reaccumulation with persistent symptoms	failure

 

A patient may show a partial benefit initially only to fail later.

 

Reasons why a chemical pleurodesis may fail:

(1) trapped lung

(2) lymphangitic tumor spread with chylothorax

(3) failure for technical reason

 

(1) repeat needle drainages

(2) placement of a chest tube

(3) placement of an indwelling, tunneled drainage catheter

(4) pleural-to-peritoneal shunt

(5) removal of the pleura (pleurectomy) if the patient is expected to survive for some time