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Original article
peer-reviewed

Experience with Ambulatory Management of Pleural Pathologies Utilizing Small-Bore Indwelling Pleural Catheters



Abstract

Introduction

Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax.

Methods

We conducted a prospective case series analysis of 15 patients with various pleural pathologies in which an indwelling pleural catheter was placed by interventional radiologists on an outpatient basis and subsequently followed-up in a pulmonary clinic. Results were analyzed on the basis of clinical, as well as radiological progress with parameters being complete, partial, or no resolution. We also obtained prospective data on the quality of life of these patients.

Results

Six out of seven patients with malignant pleural effusion reported clinical (complete or partial) resolution, while three reported radiological (complete or partial) resolution. Two of the three patients with nonmalignant pleural effusions reported complete clinical as well as radiological resolution. All three patients with empyema reported complete clinical resolution and partial radiological resolution, while both patients with primary spontaneous pneumothorax reported complete clinical and radiological resolution. Patients reported preserved or improved quality of life with the whole process managed on an outpatient basis.

Conclusion

We report a high rate of clinical and radiological resolution in various pleural pathologies in our study, which is first of its kind from this part of the world. It demonstrates the feasibility of ambulatory management of pleural pathologies with a multidisciplinary approach.



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Original article
peer-reviewed

Experience with Ambulatory Management of Pleural Pathologies Utilizing Small-Bore Indwelling Pleural Catheters


Author Information

Imad-ud-din Saqib Corresponding Author

Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan

Mobeen Iqbal

Department of Pulmonology & Critical Care, Shifa International Hospital

Atif Rana

Department of Interventional Radiology, Shifa International Hospital

Intervention Radiology, Shifa International Hospital

Saira Hassan

Hematology/oncology, Shifa International Hospital, Islamabad, Pakistan


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Institutional Review Board & Ethics Committee, Shifa International Hospital issued approval. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Original article
peer-reviewed

Experience with Ambulatory Management of Pleural Pathologies Utilizing Small-Bore Indwelling Pleural Catheters


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Original article
peer-reviewed

Experience with Ambulatory Management of Pleural Pathologies Utilizing Small-Bore Indwelling Pleural Catheters

  • Author Information
    Imad-ud-din Saqib Corresponding Author

    Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan

    Mobeen Iqbal

    Department of Pulmonology & Critical Care, Shifa International Hospital

    Atif Rana

    Department of Interventional Radiology, Shifa International Hospital

    Intervention Radiology, Shifa International Hospital

    Saira Hassan

    Hematology/oncology, Shifa International Hospital, Islamabad, Pakistan


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Institutional Review Board & Ethics Committee, Shifa International Hospital issued approval. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: September 01, 2017

    DOI

    10.7759/cureus.1636

    Cite this article as:

    Saqib I, Iqbal M, Rana A, et al. (September 01, 2017) Experience with Ambulatory Management of Pleural Pathologies Utilizing Small-Bore Indwelling Pleural Catheters. Cureus 9(9): e1636. doi:10.7759/cureus.1636

    Publication history

    Received by Cureus: August 16, 2017
    Peer review began: August 24, 2017
    Peer review concluded: August 27, 2017
    Published: September 01, 2017

    Copyright

    © Copyright 2017
    Saqib et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax.

Methods

We conducted a prospective case series analysis of 15 patients with various pleural pathologies in which an indwelling pleural catheter was placed by interventional radiologists on an outpatient basis and subsequently followed-up in a pulmonary clinic. Results were analyzed on the basis of clinical, as well as radiological progress with parameters being complete, partial, or no resolution. We also obtained prospective data on the quality of life of these patients.

Results

Six out of seven patients with malignant pleural effusion reported clinical (complete or partial) resolution, while three reported radiological (complete or partial) resolution. Two of the three patients with nonmalignant pleural effusions reported complete clinical as well as radiological resolution. All three patients with empyema reported complete clinical resolution and partial radiological resolution, while both patients with primary spontaneous pneumothorax reported complete clinical and radiological resolution. Patients reported preserved or improved quality of life with the whole process managed on an outpatient basis.

Conclusion

We report a high rate of clinical and radiological resolution in various pleural pathologies in our study, which is first of its kind from this part of the world. It demonstrates the feasibility of ambulatory management of pleural pathologies with a multidisciplinary approach.



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Create a free account to continue reading this article.

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Imad-ud-din Saqib

Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan

For correspondence:
imaduddinsaqib@gmail.com

Mobeen Iqbal

Department of Pulmonology & Critical Care, Shifa International Hospital

Atif Rana

Department of Interventional Radiology, Shifa International Hospital

Saira Hassan

Hematology/oncology, Shifa International Hospital, Islamabad, Pakistan

Imad-ud-din Saqib

Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan

For correspondence:
imaduddinsaqib@gmail.com

Mobeen Iqbal

Department of Pulmonology & Critical Care, Shifa International Hospital

Atif Rana

Department of Interventional Radiology, Shifa International Hospital

Saira Hassan

Hematology/oncology, Shifa International Hospital, Islamabad, Pakistan