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Review
. 2023 Aug;44(4):454-461.
doi: 10.1055/s-0043-1769093. Epub 2023 May 31.

Indwelling Pleural Catheter: Management of Complications

Affiliations
Review

Indwelling Pleural Catheter: Management of Complications

Calvin Sidhu et al. Semin Respir Crit Care Med. 2023 Aug.

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.

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Conflict of interest statement

Rocket Med Plc provides drainage kits without charge for patients treated with indwelling pleural catheters enrolled in a randomized clinical trial led by Y.C.G. Others report no conflict of interest.

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