Safety of pleurodesis with talc poudrage in malignant pleural effusion: a prospective cohort study
Date
2007
Authors
Janssen J.P.
Collier G.
Astoul P.
Tassi G.F.
Noppen M.
Rodriguez-Panadero F.
Loddenkemper R.
Herth F.J.
Gasparini S.
Marquette C.H.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Talc is the most effective chemical pleurodesis agent for patients with malignant pleural effusion. However, concerns have arisen about the safety of intrapleural application of talc, after reports of development of acute respiratory distress syndrome in 1-9% of treated patients. Our aim was to establish whether use of large-particle-size talc is safe in patients with malignant pleural effusion. Methods: We did a multicentre, open-label, prospective cohort study of 558 patients with malignant pleural effusion who underwent thoracoscopy and talc poudrage with 4 g of calibrated French large-particle talc in 13 European hospitals, and one in South Africa. The primary endpoint was the occurrence of acute respiratory distress syndrome after talc pleurodesis. Findings: No patients developed acute respiratory distress syndrome (frequency 0%, one-sided 95% CI 0-0·54%). 11 (2%) patients died within 30 days. Additionally, seven patients had non-fatal post-thoracoscopy complications (1·2%), including one case of respiratory failure due to unexplained bilateral pneumothorax. Interpretation: Use of large-particle talc for pleurodesis in malignant pleural effusion is safe, and not associated with the development of acute respiratory distress syndrome. © 2007 Elsevier Ltd. All rights reserved.
Description
Keywords
antibiotic agent, diuretic agent, talc, adult, adult respiratory distress syndrome, aged, article, clinical trial, cohort analysis, congestive heart failure, controlled clinical trial, controlled study, disease course, female, fever, human, hypoxemia, major clinical study, male, mortality, multicenter study, pericardial effusion, pleura biopsy, pleura effusion, pleurodesis, pneumothorax, priority journal, prospective study, recurrent disease, respiratory failure, South Africa, thoracoscopy, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Particle Size, Pleural Effusion, Malignant, Pleurodesis, Prospective Studies, Respiratory Distress Syndrome, Adult, Safety, Talc, Thoracoscopy, Treatment Outcome
Citation
Lancet
369
9572
369
9572