What criteria do you use to consider pleurodesis vs indwelling tunneled catheters in patients with malignant pleural effusion?

There are typically three approaches that are used for the management of recurrent malignant pleural effusions. The first approach is to perform repeated thoracentesis. This may be acceptable if there is a significant duration of time between recurrent symptomatic pleural effusions. The other two approaches include the placement of a tunneled indwelling pleural catheter (TIPC) or pleurodesis. Pleurodesis is usually accomplished by placing a talc slurry through a chest tube or by thoracoscopic talc poudrage.

The TIME2 study compared outcomes between patients with recurrent malignant pleural effusion who received a TIPC vs. talc pleurodesis via slurry through a chest tube. The study demonstrated that there was no difference in dyspnea between ...