Role of indwelling pleural catheters in hepatic hydrothorax

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Original Article

Author Details : S Yuvarajan, R Praveen*, Antonious Maria Selvam

Volume : 4, Issue : 3, Year : 2019

Article Page : 147-149

https://doi.org/10.18231/j.ijirm.2019.033

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Abstract

Background: Hepatic hydrothorax is characterized by the presence of moderate to massive transudative pleural effusion seen in patients with cirrhosis of the liver without overt cardiopulmonary and pleural diseases. Patients who presents with massive pleural effusion leads to respiratory distress and failure which further increases morbidity and mortality in patients with cirrhosis. Indwelling tunneled pleural catheters (IPCs) plays a major role in palliative treatment for patients with stage IV malignancy who present with recurrent massive pleural effusion. IPC helps in reducing the symptoms of dyspnoea, chest pain etc. by therapeutic pleural drainage either by themselves or with help of their caregivers. In recent days usage of IPC is increased in non-malignant benign causes of recurrent pleural effusion. The present study aimed to study the feasibility of usage of indwelling pleural catheters in hepatic hydrothorax presenting with recurrent pleural effusions.
Methodology: This study was a retrospective analysis of medical records of patients who underwent IPC insertion for hepatic hydrothorax with cirrhosis /decompensated liver disease was done.
Results: 18 patients with hepatic hydrothorax were placed with indwelling pleural catheters. Mean age of patients was 52.5 years, and the most common etiology for underlying liver disease is Alcoholic liver cirrhosis. Almost all patients were male.16 IPC (88.8%) were placed for right sided effusion only 2(11.1%) were placed for left sided effusion. Spontaneous pleurodesis was achieved in 10 of 18 patients (55.5%) and IPCs were removed in these patients. Mean time in which pleurodesis achieved was 120.8 days (range, 15–290 d).
Conclusion: Thus indwelling catheters are useful in patients with hepatic hydrothorax with refractory pleural effusion. It also improves the quality of life and alleviates dyspnoea in those patients. However further studies are needed with larger sample size.

Keywords: Hepatic hydrothorax; Indwelling pleural catheters; Recurrent pleural effusion.

How to cite : Yuvarajan S, Praveen R, Selvam A M, Role of indwelling pleural catheters in hepatic hydrothorax. IP Indian J Immunol Respir Med 2019;4(3):147-149

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