Document Detail


Efficacy of short term versus long term tube thoracostomy drainage before tetracycline pleurodesis in the treatment of malignant pleural effusions.
MedLine Citation:
PMID:  7512285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A study was undertaken to compare the efficacy of short term tube thoracostomy drainage with standard tube thoracostomy drainage before instillation of tetracycline for sclerotherapy of malignant pleural effusions. METHODS: The study consisted of a randomised clinical trial in a sequential sample of 25 patients with malignant pleural effusions documented cytopathologically. Fifteen patients were randomly assigned to group 1 (standard protocol) and 10 to group 2 (short term protocol). Patients in group 1 had tube thoracostomy suction drainage until radiological evidence of lung re-expansion was obtained and the amount of fluid drained was < 150 ml/day, before tetracycline (1.5 g) was instilled. The chest tube was removed when the amount of fluid drained after instillation was < 150 ml/day. Patients in group 2 also had suction drainage, but the tetracycline (1.5 g) was instilled when the chest radiograph showed the lung to be re-expanded and the effusion drained, which was usually within 24 hours. The chest tube was removed the next day. RESULTS: The response to tetracycline sclerotherapy in the two groups was the same (80%) but the duration of chest tube drainage was significantly shorter for patients in group 2 (median two days) than for those in group 1 (median seven days). CONCLUSIONS: The duration of chest tube drainage before sclerotherapy for malignant pleural effusions need not be influenced by the amount of fluid drained daily but by radiographic evidence of fluid evacuation and lung re-expansion. Shorter duration of drainage will reduce the length of hospital stay without sacrificing the efficacy of pleurodesis.
Authors:
A G Villanueva; A W Gray; D M Shahian; W A Williamson; J F Beamis
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Thorax     Volume:  49     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-05-12     Completed Date:  1994-05-12     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  23-5     Citation Subset:  IM    
Affiliation:
Section of Pulmonary and Critical Care Medicine, Lahey Clinic, Burlington, Massachusetts 01805.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chest Tubes*
Drainage / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Palliative Care / methods
Pleural Effusion / therapy*
Prospective Studies
Sclerotherapy*
Tetracycline / therapeutic use*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
60-54-8/Tetracycline
Comments/Corrections
Comment In:
Thorax. 1995 Jan;50(1):104   [PMID:  7886641 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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