The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies: A multicenter study

Christopher R. Gilbert*, Hans J. Lee, Joseph H. Skalski, Fabien Maldonado, Momen Wahidi, Philip J. Choi, Jamie Bessich, Daniel Sterman, A. Christine Argento, Samira Shojaee, Jed A. Gorden, Candice L. Wilshire, David Feller-Kopman, Ricardo Ortiz, Bareng Aletta Sanny Nonyane, Lonny Yarmus

*Corresponding author for this work

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports. RESULTS: Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection. CONCLUSIONS: We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7% infection risk and 2.2% mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia oft en present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.

Original languageEnglish (US)
Pages (from-to)752-758
Number of pages7
JournalCHEST
Volume148
Issue number3
DOIs
StatePublished - Sep 1 2015

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Gilbert, C. R., Lee, H. J., Skalski, J. H., Maldonado, F., Wahidi, M., Choi, P. J., Bessich, J., Sterman, D., Argento, A. C., Shojaee, S., Gorden, J. A., Wilshire, C. L., Feller-Kopman, D., Ortiz, R., Nonyane, B. A. S., & Yarmus, L. (2015). The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies: A multicenter study. CHEST, 148(3), 752-758. https://doi.org/10.1378/chest.14-3119