• Calvin Sidhu, Helen E Davies, Sanjeevan Muruganandan, LuiMacy M SMMSDivision of Respiratory Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong., Estee P M Lau, and LeeY C GaryYCGPleural Medicine Unit, Institute for Respiratory Health, Perth, Australia.Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia.School of Medicine, University of Western Australia, Perth, Australia..
• Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia.
• Semin Respir Crit Care Med. 2023 Aug 1; 44 (4): 454461454-461.

AbstractMultiple randomized clinical trials have established the advantages of indwelling pleural catheter (IPC) in the management of malignant pleural effusions, resulting in its widespread adoption in clinical practice. Complications can occur with IPC use and must be recognized and managed effectively. This review provides a comprehensive overview of IPC complications and their best care. Pain postinsertion or during drainage of IPC is easily manageable and must be distinguished from tumor-related chest wall pain. IPC-related infections require systemic antibiotics and often intrapleural fibrinolytic/deoxyribonuclease therapy. The removal of IPC for infection is usually unnecessary. Symptomatic loculation usually responds to fibrinolytics but may recur. Catheter tract metastases are common in mesothelioma patients and usually respond to radiotherapy without inducing damages to the IPC. Less common complications include dislodgement, irreversible blockage, and fractures (upon removal) of the catheter. Recommendations on the management of IPC complications by recent consensus statement/guideline are discussed. Expert opinions on management approaches are included in areas where evidence is lacking to guide care.Thieme. All rights reserved.

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