Huan-zhong SHI. Rational and Helpless Choices: Seven Issues of 2018 ATS/STS/STR Management Guideline for the Malignant Pleural Effusion[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(6): 566-568. doi: 10.3969/j.issn.1674-9081.2018.06.015
Citation: Huan-zhong SHI. Rational and Helpless Choices: Seven Issues of 2018 ATS/STS/STR Management Guideline for the Malignant Pleural Effusion[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(6): 566-568. doi: 10.3969/j.issn.1674-9081.2018.06.015

Rational and Helpless Choices: Seven Issues of 2018 ATS/STS/STR Management Guideline for the Malignant Pleural Effusion

doi: 10.3969/j.issn.1674-9081.2018.06.015
More Information
  • Author Bio:

    SHI Huan-zhong: 101-85231890, E-mail:shihuanzhong@sina.com

  • Received Date: 2018-10-08
  • Publish Date: 2018-11-30
  • "Management of malignant pleural effusions (MPE)", an official clinical practice guideline approved by the American Thoracic Society, the Society of Thoracic Surgeons, and the Society of Thoracic Radiology, was published in the American Journal of Respiratory and Critical Care Medicine on October 1st, 2018. Using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach and the PICO (Population, Intervention, Comparator, and Outcomes) format, a multidisciplinary panel raised and answered seven questions on the clinical management of MPE. The relevant evidences were summarized and recommendations were developed for clinical practice. Based on the available evidence, the panel made the following recommendations:(1)ultrasound imaging should be used to guide pleural interventions in patients with known or suspected MPE; (2)therapeutic pleural interventions should not be performed in asymptomatic patients with known or suspected MPE; (3)either an indwelling pleural catheter (IPC) or chemical pleurodesis can be used in symptomatic patients with MPE and suspected expandable lung; (4)large-volume thoracentesis can be conducted to assess symptomatic response and lung expansion; (5)the use of either talc poudrage or talc slurry can be considered in patients with symptomatic MPE and expandable lung; (6)IPC should be used instead of pleurodesis in patients with nonexpandable lung or failed pleurodesis; and (7)antibiotics should be used in IPC-associated infections and there is no need to removed the catheter.
  • loading
  • [1] Taghizadeh N, Fortin M, Tremblay A. US hospitalizations for malignant pleural effusions:data from the 2012 National Inpatient Sample[J]. Chest, 2017, 151:845-854. doi:  10.1016/j.chest.2016.11.010
    [2] Porcel JM, Gasol A, Bielsa S, et al. Clinical features and survival of lung cancer patients with pleural effusions[J]. Respirology, 2015, 20:654-659. doi:  10.1111/resp.12496
    [3] Feller-Kopman D, Light R. Pleural disease[J]. N Engl J Med, 2018, 378:740-751. doi:  10.1056/NEJMra1403503
    [4] American Thoracic Society. Management of malignant pleural effusions[J]. Am J Respir Crit Care Med, 2000, 162:1987-2001. doi:  10.1164/ajrccm.162.5.ats8-00
    [5] Roberts ME, Neville E, Berrisford RG, et al. Management of a malignant pleural effusion:British Thoracic Society Pleural Disease Guideline 2010[J]. Thorax, 2010, 65 Suppl 2:ii32-ii40. http://www.ncbi.nlm.nih.gov/pubmed/20696691
    [6] Scarci M, Caruana E, Bertolaccini L, et al. Current practices in the management of malignant pleural effusions:a survey among members of the European Society of Thoracic Surgeons[J]. Interact Cardiovasc Thorac Surg, 2017, 24:414-417. http://cn.bing.com/academic/profile?id=9c195bcbe7bbe08618e1817b6ab4e97c&encoded=0&v=paper_preview&mkt=zh-cn
    [7] Feller-Kopman DJ, Reddy CB, DeCamp MM, et al. Management of malignant pleural effusions. An official ATS/STS/STR clinical practice guideline[J]. Am J Respir Crit Care Med, 2018, 198:839-849. http://www.socolar.com/Article/Index?aid=100037207520&jid=100000008018
    [8] Bhatnagar R, Keenan EK, Morley AJ, et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion[J]. N Engl J Med, 2018, 378:1313-1322. doi:  10.1056/NEJMoa1716883
    [9] Xia H, Wang XJ, Zhou Q, et al. Efficacy and safety of talc pleurodesis for malignant pleural effusion:a meta-analysis[J]. PLoS One, 2014, 9:e87060. doi:  10.1371/journal.pone.0087060
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (353) PDF downloads(358) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return