Eastern Cardiothoracic Surgical Society

Improving Lives with Tunneled Pleural Catheters
Mrinalini Krishnan, Hardik Bhatt, Hassan Al-Khalisy, Troy Moritz, PinnacleHealth Hospital, Harrisburg, PA

OBJECTIVE:The objective of this study was to assess the off-label use of tunneled pleural catheters (TPCs) to drain recurrent pleural effusions resulting from non-malignant conditions.

METHODS: A retrospective chart review was done of 98 patients following insertion of TPCs for recurrent pleural effusions. Patients were set up with homecare nursing support and draining 2-3 times per week, then followed as outpatients until spontaneous pleurodesis and catheter removal. Data collection included demographics (age, sex) and co-morbidities (hypertension, chronic kidney disease, congestive heart failure, liver disease and malnutrition). Data also included surveying patients with the Functional Assessment of Chronic Illness Therapy – Treatment Satisfaction – General (FACIT-TS-G) survey for satisfaction with the treatment, as well as the Modified Medical Research Council (MMRC) Dyspnea Scale to assess symptoms before to after treatment with TPCs. Deceased patients and those with malignant pleural effusions were excluded. Data was analyzed by students t-test.

RESULTS: Eleven patients with recurrent, non-malignant pleural effusions were enrolled (6 females, 5 males). Of the 11 patients, 10 (90.9%) would recommend the treatment to others with the same condition, and 8 (72.7%) would choose the treatment again. Using the MMRC Dyspnea Scale, the mean score improved from 2.91/4 (SD 1.38) to 0.73/4 (SD 0.79), showing an absolute improvement of -2.18, p-value 0.0006.

CONCLUSIONS: There was general satisfaction found among patients with the TPCs placed for recurrent non-malignant pleural effusions, with a significant decrease in dyspnea also reported amongst these patients.

Patient Characteristics
Total Number of Patients 11
Age (Mean, SD, Range) 74.2 +/- 14.4 32 – 90
Gender (Female, n, %) 6 54.5%
Co-morbid Conditions (n, %)
Hypertension 9 81.8%
Chronic Kidney Disease 7 63.6%
Congestive Heart Failure 9 81.8%
Liver Disease 1 91.9%
Malnutrition 3 27.3%
Multiple Conditions 10 90.9%