Indwelling Pleural Catheter: Management of Complications

Calvin Sidhu; Helen E. Davies; Sanjeevan Muruganandan; Macy M. S. Lui; Estee P. M. Lau; Y. C. Gary Lee

doi:10.1055/s-0043-1769093

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2023; 44(04): 454-461
DOI: 10.1055/s-0043-1769093

Review Article

Indwelling Pleural Catheter: Management of Complications

Calvin Sidhu

¹Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia

²School of Medical and Health Sciences, Edith Cowan University, Perth, Australia

³Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia

,

Helen E. Davies

⁴Department of Respiratory Medicine, University Hospital of Wales, Cardiff, United Kingdom

,

Sanjeevan Muruganandan

⁵Department of Respiratory Medicine, Northern Health, Melbourne, Australia

⁶Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia

,

Macy M. S. Lui

⁷Division of Respiratory Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong

,

Estee P. M. Lau

¹Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia

²School of Medical and Health Sciences, Edith Cowan University, Perth, Australia

,

Y. C. Gary Lee

¹Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia

³Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia

⁸School of Medicine, University of Western Australia, Perth, Australia

› Institutsangaben

Abstract

Multiple randomized clinical trials have established the advantages of indwelling pleural catheter (IPC) in the management of malignant pleural effusions, resulting in its widespread adoption in clinical practice. Complications can occur with IPC use and must be recognized and managed effectively. This review provides a comprehensive overview of IPC complications and their best care. Pain postinsertion or during drainage of IPC is easily manageable and must be distinguished from tumor-related chest wall pain. IPC-related infections require systemic antibiotics and often intrapleural fibrinolytic/deoxyribonuclease therapy. The removal of IPC for infection is usually unnecessary. Symptomatic loculation usually responds to fibrinolytics but may recur. Catheter tract metastases are common in mesothelioma patients and usually respond to radiotherapy without inducing damages to the IPC. Less common complications include dislodgement, irreversible blockage, and fractures (upon removal) of the catheter. Recommendations on the management of IPC complications by recent consensus statement/guideline are discussed. Expert opinions on management approaches are included in areas where evidence is lacking to guide care.

Keywords

indwelling catheter - pleural - complications

Volltext

Referenzen

References
1 Taghizadeh N, Fortin M, Tremblay A. US hospitalizations for malignant pleural effusions: data from the 2012 national inpatient sample. Chest 2017; 151 (04) 845-854
2 Koegelenberg CFN, Shaw JA, Irusen EM, Lee YCG. Contemporary best practice in the management of malignant pleural effusion. Ther Adv Respir Dis 2018; 12: 1753466618785098
3 Thomas R, Roy B, Maldonado F, Lee YCG. Management of malignant pleural effusions—what is new. Semin Respir Crit Care Med 2019; 40 (03) 323-339
4 Davies HE, Mishra EK, Kahan BC. et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA 2012; 307 (22) 2383-2389
5 Bhatnagar R, Keenan EK, Morley AJ. et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion. N Engl J Med 2018; 378 (14) 1313-1322
6 Muruganandan S, Azzopardi M, Fitzgerald DB. et al. Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial. Lancet Respir Med 2018; 6 (09) 671-680
7 Wahidi MM, Reddy C, Yarmus L. et al. Randomized trial of pleural fluid drainage frequency in patients with malignant pleural effusions. The ASAP trial. Am J Respir Crit Care Med 2017; 195 (08) 1050-1057
8 Matta A. Indwelling pleural catheters for benign pleural effusions: a concise review. Curr Opin Pulm Med 2023; 29 (01) 37-42
9 Wang S, Zhang R, Wan C. et al. Incidence of complications from indwelling pleural catheter for pleural effusion: a meta-analysis. Clin Transl Sci 2023; 16 (01) 104-117
10 Miller RJ, Chrissian AA, Lee YCG. et al. AABIP evidence-informed guidelines and expert panel report for the management of indwelling pleural catheters. J Bronchology Interv Pulmonol 2020; 27 (04) 229-245
11 Gilbert CR, Wahidi MM, Light RW. et al; Interventional Pulmonary Outcomes Group. Management of indwelling tunneled pleural catheters: a modified Delphi consensus statement. Chest 2020; 158 (05) 2221-2228
12 Thomas R, Fysh ETH, Smith NA. et al. Effect of an indwelling pleural catheter vs talc pleurodesis on hospitalization days in patients with malignant pleural effusion: the AMPLE randomized clinical trial. JAMA 2017; 318 (19) 1903-1912
13 Van Meter ME, McKee KY, Kohlwes RJ. Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review. J Gen Intern Med 2011; 26 (01) 70-76
14 Sarah Jane Messeder MT. Graeme Currie, Mahendran Chetty. Patient satisfaction and perception of indwelling pleural catheters. Eur Respir J 2019; 54 (Suppl. 63) PA4648
15 Ost DE, Jimenez CA, Lei X. et al. Quality-adjusted survival following treatment of malignant pleural effusions with indwelling pleural catheters. Chest 2014; 145 (06) 1347-1356
16 Tremblay A, Michaud G. Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion. Chest 2006; 129 (02) 362-368
17 Miyazaki T, Sakai T, Yamasaki N. et al. Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery. Gen Thorac Cardiovasc Surg 2014; 62 (01) 58-63
18 Bhatnagar R, Maskell NA. Indwelling pleural catheters. Respiration 2014; 88 (01) 74-85
19 Fysh ETH, Tremblay A, Feller-Kopman D. et al. Clinical outcomes of indwelling pleural catheter-related pleural infections: an international multicenter study. Chest 2013; 144 (05) 1597-1602
20 Mekhaiel E, Kashyap R, Mullon JJ, Maldonado F. Infections associated with tunnelled indwelling pleural catheters in patients undergoing chemotherapy. J Bronchology Interv Pulmonol 2013; 20 (04) 299-303
21 Morel A, Mishra E, Medley L. et al. Chemotherapy should not be withheld from patients with an indwelling pleural catheter for malignant pleural effusion. Thorax 2011; 66 (05) 448-449
22 Lui MM, Thomas R, Lee YC. Complications of indwelling pleural catheter use and their management. BMJ Open Respir Res 2016; 3 (01) e000123
23 Hak CC, Sivakumar P, Ahmed L. Safety of indwelling pleural catheter use in patients undergoing chemotherapy: a five-year retrospective evaluation. BMC Pulm Med 2016; 16: 41
24 Faiz SA, Pathania P, Song J. et al. Indwelling pleural catheters for patients with hematologic malignancies. A 14-year, single-center experience. Ann Am Thorac Soc 2017; 14 (06) 976-985
25 Mitchell MA, Burkett A, Li P, Zhang T, Amjadi K. Effect of chemotherapy on removal of indwelling pleural catheters in breast cancer patients with malignant pleural effusions. Respiration 2018; 96 (06) 552-559
26 Avula A, Acharya S, Anwar S. et al. Indwelling pleural catheter (IPC) for the management of hepatic hydrothorax: the known and the unknown. J Bronchology Interv Pulmonol 2022; 29 (03) 179-185
27 Maskell NA, Davies CW, Nunn AJ. et al; First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med 2005; 352 (09) 865-874
28 Gilbert CR, Lee HJ, Akulian JA. et al. A quality improvement intervention to reduce indwelling tunneled pleural catheter infection rates. Ann Am Thorac Soc 2015; 12 (06) 847-853
29 Fitzgerald DB, Muruganandan S, Tsim S. et al. Intrapleural fibrinolytics and deoxyribonuclease for treatment of indwelling pleural catheter-related pleural infection: a multi-center observational study. Respiration 2021; 100 (05) 452-460
30 Rahman NM, Maskell NA, West A. et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med 2011; 365 (06) 518-526
31 Feller-Kopman DJ, Reddy CB, DeCamp MM. et al. Management of malignant pleural effusions. An official ATS/STS/TR clinical practice guideline. Am J Respir Crit Care Med 2018; 198 (07) 839-849
32 Szeto CC, Chow KM, Wong TY, Leung CB, Li PK. Conservative management of polymicrobial peritonitis complicating peritoneal dialysis—a series of 140 consecutive cases. Am J Med 2002; 113 (09) 728-733
33 Li PK, Chow KM, Cho Y. et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022; 42 (02) 110-153
34 Banka R, Terrington D, Mishra EK. Management of septated malignant pleural effusions. Curr Pulmonol Rep 2018; 7 (01) 1-5
35 Chung CL, Chen YC, Chang SC. Effect of repeated thoracenteses on fluid characteristics, cytokines, and fibrinolytic activity in malignant pleural effusion. Chest 2003; 123 (04) 1188-1195
36 Chee A, Tremblay A. The use of tunneled pleural catheters in the treatment of pleural effusions. Curr Opin Pulm Med 2011; 17 (04) 237-241
37 Thomas R, Piccolo F, Miller D. et al. Intrapleural fibrinolysis for the treatment of indwelling pleural catheter-related symptomatic loculations: a multicenter observational study. Chest 2015; 148 (03) 746-751
38 Lan NSH, Vekaria S, Sidhu C, Lee YCG. Very low-dose intrapleural tPA for indwelling pleural catheter-associated symptomatic fluid loculation. Respirol Case Rep 2019; 7 (07) e00457
39 Chalhoub M, Saqib A, Castellano M. Indwelling pleural catheters: complications and management strategies. J Thorac Dis 2018; 10 (07) 4659-4666
40 Nasim F, Folch E, Majid A. Tunneled pleural catheter dysfunction: case report and review of complications. J Bronchology Interv Pulmonol 2012; 19 (02) 149-152
41 Bhatnagar R, Reid ED, Corcoran JP. et al. Indwelling pleural catheters for non-malignant effusions: a multicentre review of practice. Thorax 2014; 69 (10) 959-961
42 Frost N, Ruwwe-Glösenkamp C, Raspe M. et al. Indwelling pleural catheters for non-malignant pleural effusions: report on a single centre's 10 years of experience. BMJ Open Respir Res 2020; 7 (01) e000501
43 Janes SM, Rahman NM, Davies RJ, Lee YC. Catheter-tract metastases associated with chronic indwelling pleural catheters. Chest 2007; 131 (04) 1232-1234
44 Agarwal PP, Seely JM, Matzinger FR. et al. Pleural mesothelioma: sensitivity and incidence of needle track seeding after image-guided biopsy versus surgical biopsy. Radiology 2006; 241 (02) 589-594
45 Mitchell MA, Li P, Pease C. et al. Catheter tract metastasis in mesothelioma patients with indwelling pleural catheters: a retrospective cohort study. Respiration 2019; 97 (05) 428-435
46 Thomas R, Budgeon CA, Kuok YJ. et al. Catheter tract metastasis associated with indwelling pleural catheters. Chest 2014; 146 (03) 557-562
47 Clive AO, Kahan BC, Hooper CE. et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax 2014; 69 (12) 1098-1104
48 Hamad F, Souza C, Mitchell M, Amjadi K. Tract metastasis in patients with long-term pleural catheter-computed tomography diagnosis and longitudinal assessment. Eur Radiol 2021; 31 (10) 7325-7331
49 Shrestha RL, Wood BA, Lee YCG. Pseudo-tumor mimicking indwelling pleural catheter tract metastasis in mesothelioma. J Bronchology Interv Pulmonol 2014; 21 (04) 350-352
50 Clive AO, Taylor H, Dobson L. et al. Prophylactic radiotherapy for the prevention of procedure-tract metastases after surgical and large-bore pleural procedures in malignant pleural mesothelioma (SMART): a multicentre, open-label, phase 3, randomised controlled trial. Lancet Oncol 2016; 17 (08) 1094-1104
51 Bayman N, Appel W, Ashcroft L. et al. Prophylactic irradiation of tracts in patients with malignant pleural mesothelioma: an open-label, multicenter, phase III randomized trial. J Clin Oncol 2019; 37 (14) 1200-1208
52 Baas P, Fennell D, Kerr KM, Van Schil PE, Haas RL, Peters S. ESMO Guidelines Committee. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 (Suppl. 05) v31-v39
53 Woolhouse I, Bishop L, Darlison L. et al. BTS guideline for the investigation and management of malignant pleural mesothelioma. BMJ Open Respir Res 2018; 5 (01) e000266
54 Scherpereel A, Astoul P, Baas P. et al; European Respiratory Society/European Society of Thoracic Surgeons Task Force. Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma. Eur Respir J 2010; 35 (03) 479-495
55 Fysh ETH, Wrightson JM, Lee YCG, Rahman NM. Fractured indwelling pleural catheters. Chest 2012; 141 (04) 1090-1094
56 Matus I, Colt H. Pleural catheter fracture during ipc removal: an under-reported complication. J Bronchology Interv Pulmonol 2021; 28 (01) e1-e3
57 Gilbert CR, Wilshire CL, Gorden JA. Retained granulation cuff as a complication of indwelling pleural catheter removal. J Bronchology Interv Pulmonol 2021; 28 (02) 156-159
58 DePew ZS, Iqbal S, Mullon JJ, Nichols FC, Maldonado F. The role for tunneled indwelling pleural catheters in patients with persistent benign chylothorax. Am J Med Sci 2013; 346 (05) 349-352
59 Jimenez CA, Mhatre AD, Martinez CH, Eapen GA, Onn A, Morice RC. Use of an indwelling pleural catheter for the management of recurrent chylothorax in patients with cancer. Chest 2007; 132 (05) 1584-1590
60 Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg 2007; 32 (02) 362-369
61 Recuero Díaz JL, Figueroa Almánzar S, Gálvez Muñoz C. et al. Recommendations of the Spanish Society of Thoracic Surgery for the management of malignant pleural effusion. Cir Esp (Engl Ed) 2022; 100 (11) 673-683 (Engl Ed)